Nursing Notes

June 7, 2012

Patient location, gloves, worker type predict hand hygiene compliance

Filed under: Nursing — Shirley @ 5:33 am
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Here’s another article on the ever growing battle about handwashing in the hospital.  It is true that strict adherence to handwashing policy will save lives and money, but for some reason we have trouble following this simple policy.  Why is that?  Maybe there is not enough time in a shift to do all the handwashing called for?   I don’t have any answers, but would love to hear your take on this growing concern.

This article is from FierceHealthcare, which is a source I like very much.  I find many interesting articles about medicine and nursing here and you will, too.

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Patients who receive care in a hallway bed are the most likely victims of healthcare workers not washing their hands, according to researchers from Boston’s Brigham and Women’s Hospital in a study to be published in the November Infection Control and Hospital Epidemiology.

In the largest hand hygiene study with more than 5,800 patient encounters in the emergency department (ED), researchers found that bed location, the type of healthcare worker providing the care, and whether the provider used gloves all were predictors of poor hand hygiene in the ED.

“We found that receiving care in a hallway bed was the strongest predictor of your healthcare providers not washing their hands,” said study author Dr. Arjun Venkatesh, an emergency medicine resident at Brigham and Women’s Hospital, in a Society of Healthcare Epidemiology of America press release yesterday.

In addition, researchers found that workers transporting patients were less likely to wash their hands because they likely do not receive as much hand hygiene training as others, according to the press release. They also said that providers using gloves was not a substitute for handwashing in controlling infections.

However, in most cases (90 percent of time), ED workers do wash their hands.

Handwashing could save up to $33 billion, according to a UPI article. In a Health Affairs study, infection control interventions such as handwashing resulted in patients leaving two days earlier and reduced mortality rates by 2 percentage points. Hospital costs also were $12,000 less, according to the article.

For more information:
– read the press release
– here’s the study abstract
– read the UPI article

Related Articles:
Hospital workers comply with hand hygiene signs about patients, not themselves
CDC: Physician offices too lax about infection control
Handwashing more common in public restrooms than in hospitals
Doctors, nurses don’t want patients to bug them about handwashing
Is 100 percent compliance on handwashing possible?

Read more: Patient location, gloves, worker type predict hand hygiene compliance – FierceHealthcare http://www.fiercehealthcare.com/story/patient-location-gloves-worker-type-predict-hand-hygiene-compliance/2011-10-04?utm_medium=nl&utm_source=internal#ixzz1x6O2AD00
Subscribe: http://www.fiercehealthcare.com/signup?sourceform=Viral-Tynt-FierceHealthcare-FierceHealthcare

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January 8, 2012

Most in-hospital adverse events unreported: OIG

Here is an article from ModernHealthcare.com  that addresses the failure to report events causing patient

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harm.  The article goes on to point out reasons for such a failure and the reasoning does make sense.  However, I feel quite strongly that if nurses had the time to make reports and if those reports were simple and easy, there would be quite a few made.  As it is, nurses are drowning in patient loads, paperwork, and have little to no time to eat or use the restroom, so forgive me if we sometimes don’t stay after our shift to enter cumbersome reports into the computer about events that really did not cause harm but could have.

Please read this article and I would love to hear your take on this topic.

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By Maureen McKinney

Posted: January 6, 2012 – 4:00 pm ET
Read more: Most in-hospital adverse events unreported: OIG – Healthcare business news and research | Modern Healthcare http://www.modernhealthcare.com/article/20120106/NEWS/301069970#ixzz1isnhQ09U
?trk=tynt

The vast majority of in-hospital adverse events go unreported by staff, according to a report from HHS’ inspector general’s office (PDF).

Using a month of survey data from a sample of 189 hospitals, the inspector general’s office found that hospitals’ voluntary incident reporting systems captured only about 14% of events that cause patient harm, such as medication errors. Federal investigators attributed low reporting rates, at least in part, to poor knowledge among hospital staff about what patient harm actually means.

“For example, staff reported only one of 17 sample events related to catheter usage (e.g., infection and urinary retention), a common cause of harm to Medicare beneficiaries,” according to the report.Other types of events that went unreported included cases of excessive bleeding related to misuse of blood thinning medications, and hospital-acquired infections.Incident reporting systems are a requirement for participation in Medicare, but a lack of uniform requirements—such as lists staff can use to identify patient harms—can damage the systems’ reliability, according to the report.“Because hospitals rely on incident reporting systems to track and analyze events, improving the usefulness of these systems is critical to hospitals’ efforts to improve patient safety,” the report said.

The report urged the CMS and HHS’ Agency for Healthcare Research and Quality to develop a list of adverse events for hospitals to use. Additionally, the office said, the CMS should reassess its methods for judging hospital compliance with the reporting-system requirement.

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December 26, 2011

Please thank your nurse this Christmas

Filed under: Nursing — Shirley @ 11:41 am
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Here’s an article that I found on CNN that I hope you will enjoy.  Christmas is one time of the year when nurses have to sacrifice time with family to care for patients.  It’s nice to see in print that someone, somewhere notices. 

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Anthony Youn, M.D., is a plastic surgeon in Metro Detroit. He is the author of “In Stitches,” a humorous memoir about growing up Asian American and becoming a doctor.

You can guarantee that three places will be open on Christmas day: Chinese restaurants, Denny’s and hospitals.

I spent part of last Christmas in the hospital visiting my mother-in-law who was recovering from open heart surgery.  I felt depressed walking into the building that morning.  My mother-in-law treasures the holidays more than anyone else in my family.  Lying in a hospital bed was the absolute last way she wanted to spend Christmas.

But during the time I spent at her bedside, my depression lifted, replaced by an overwhelming sense of gratitude for her doctors, nurses, and medical technicians.  I never felt for one second that her care suffered because her medical team was working on Christmas.  The nurses and support staff were cheerful, accommodating and responsive. One male nurse even wore a Santa’s cap and greeted my mother-in-law with “Merry Christmas” and “Ho-ho-ho” before he took her blood pressure.

Most physicians who work on Christmas – with some exceptions like ER docs – round on patients in the morning so they can get back home in time for Christmas dinner.  Not so for nurses and other hospital employees.  They put in full or extended shifts on Christmas to make sure that all the patients are cared for.  Thankfully, hospitals never close; medical care never takes days off.

Each Christmas, nurses and hospital support staff juggle their work schedules and sacrifice their time, giving up their own Christmases to accommodate the needs of patients.  As I sat by my mother-in-law’s bedside and looked forward to my own Christmas dinner, I thought about the dedicated caregivers who would spend their day changing catheters and cleaning wounds while the rest of us enjoyed being with our families in the warmth of our homes.

Some nurses go way beyond the call of duty.  A few years ago I went to the hospital on Christmas morning to see a patient who had undergone reconstructive surgery.  Her nurse, Sara, smiled as she worked.  Even so, I thought she looked a little tired.  I asked her how she was doing.  She told me she was working her second twelve-hour shift in two days.  She was covering for a nurse who had called in sick.  You would never know it. Sara was professional, caring and attentive to my patient, as well as to the five other patients assigned to her.  I was in awe of Sara.

Operating on almost no sleep, she was spending Christmas working in the hospital, instead of with her small children, and she was going about her job cheerfully without complaint and with consummate professionalism…[read more]

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October 27, 2011

Engage Nurses to Raise Your Patient Safety Scores

Filed under: Nursing — Shirley @ 1:13 pm
Tags: , , , , ,

Here is an article about patient safety and who owns the indices.  This article is good, in that it talks about how top-down changes never stick and that you have to involve and empower the hands-on staff if you want to make lasting changes.  That I like.  What I was not too keen on, and I could be way off target here, is it also felt that nurses not taking ownership because of administrations policy and ways of dealing with the problem, was somehow to blame for there still being a problem.

After reading the article, I felt “there’s just another thing to throw on the nurse’s plate” when nurses everywhere are already struggling to stay current and afloat with all the healthcare changes that are in the works.  Nurses just want to nurse.  Period.  Let them do what they became nurses to do and maybe some of these problelms would disappear.  However, you would have to have enough nurses first so that each nurse could actually do the nursing she/he went to school to do.  What a concept!  I’m being sarcastic, in case that does not translate well in print.

Here’s the article from HealthLeadersMedia.com so you can read it and decide for yourself how it makes you think and feel.  Let me know, won’t you?

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Rebecca Hendren, for HealthLeaders Media , October 25, 2011

Who owns the quality measure and patient outcome scores in your hospital? Most hospitals have quality, safety, and infection prevention professionals devoted solely to these statistics and ways to improve them.

All their efforts are meaningless unless nurses and other clinical staff are engaged in the process. Too often, they are not. Most staff nurses don’t know what value-based purchasing is or why they should care about it. All they know is that when Administration or “Quality” has a new scheme it will take nurses more time to do their jobs.

Nurses may fully support the changes because they will benefit patients, but they don’t own them and they don’t own those scores.

As the people who actually touch patients, all members of the nursing staff need to feel directly responsible for patient safety. Quality improvement becomes one more meaningless directive from “above” unless nurses feel engaged in the process, involved in the plans, and accountable for the results.

“Culture eats strategy for lunch,” says Mary J. Voutt-Goos, MSN, RN, CCRN, director, Patient Safety Initiatives and Clinical Care Design at Henry Ford Health System in Detroit. “If frontline staff aren’t in agreement and actively engaged in the process, it won’t happen. Top-down approaches to culture change are typically unsuccessful.”

This is one reason why scores can start creeping downward after a successful quality improvement effort has come and gone. If nurses aren’t engaged in the process, they have less inclination to remain on a directed path.

“All frontline staff, not just nurses, should be engaged, as well as empowered to act, if we really want to see a change in our culture of safety,” says Voutt-Goos.

One way to build a feeling of accountability in nurses is to empower them to solve the problems themselves—in conjunction with quality and patient safety professionals, of course. New procedures or processes are more likely to be met with acceptance and to become part of everyday practice when the caregivers themselves are involved in the design.

At Henry Ford Health System, the organization studied aviation industry principles of safety cultures and safety climate literature and identified global indicators of safety culture.

“We use these global indicators as a guiding framework for our culture of safety efforts,” said  Voutt-Goos. “One of the global indicators is employee empowerment.”

Empowering employees involves giving them a level of responsibility and knowledge, which sometimes they may not want, but is vital to achieving an end result of quality patient care in a financially healthy organization.

One common practice to reduce outcomes-related to issues such as patient falls or CAUTIs is to pit units against each other in competition and reward the winner with a pizza or ice cream. While it’s appropriate to celebrate success and recognize hard work, I think it’s a mistake to rely too heavily on competition.

Rewarding the unit that most improves its customer satisfaction scores or reduces patient falls by the greatest percentage is great at building enthusiasm and recognizing hard work, but it’s not an effective long-term strategy. Nurses should be treated like adults and involved in the imperatives behind process improvement, both those related to patient care and those related to the organization’s bottom line.

Just as the hospital should treat nurses as adults, nursing staff should be more interested in quality outcomes. They must seek out and embrace their level of ownership in these metrics. In today’s financial reality, it is no longer acceptable to not take an active role in quality improvement efforts. Organizations should engage nurses in frank and honest communication.

The financial imperative is such that hospitals can’t afford…[read more]

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October 5, 2011

Nurses Don’t Want To Be Doctors

Here is an interesting article about the discord between nurses with graduate degrees and physicians.  This is a “hot topic” right now as the ANA encourages more and more nurses to pursue higher education as a means of advancing the practice of nursing.
Physicians have a point, I guess.  But mostly I think that they have missed the point. Nurses do not want to BE physicians, they want to be nurses.  But they want to be the best nurses they can be.  Receiving your doctorate in nursing only means that you value the profession and you want to pass on to your patients the benefit of you learning.  Nurses are much more global thinkers than physicians.  We are trained to look at the whole picture and then figure out the way the symptoms are affecting the persons health.  Doctors are symptom driven and deal with specifics.  Have you ever gone to the doctor with a complaint of, “I just don’t feel right” and gotten a concerned and interested response.  The usual response would be to send you for a million tests to rule out things.  Nurses will get inquisitive and ask lots and lots of personal questions until they have an “ah-ha” moment.
This article is from HealthLeadersmedia, which I have used before.  I really love this site and hope that you will click over to finish reading this great article.  Leave us both a comment about your take on this issue, won’t you?
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Rebecca Hendren, for HealthLeaders Media, October 4, 2011

As a child addressing thank you notes for birthday gifts, I was perplexed by the one relative whose address began “Dr. and Mrs. John Doe.” I knew he was not a Doctor and yet he was called doctor. My mother explained he was a doctor, but not a “Doctor,” and you can imagine the emphasis on the second doctor.

This was my first introduction to the confusing world of honorifics and it hasn’t become any simpler since.

We all know that the title “doctor” refers both to physicians with medical degrees and to people who have been awarded a doctorate in a certain subject. These days patients often visit “the doctor” and are seen by a nurse who has an advanced practice degree and whose title includes the right to use the honorific term doctor.

Physician groups have been voicing concerns that the growing numbers of nurses who are also doctors are confusing for patients. Nurses are concerned that advanced practice professionals who have received doctorates in their field are afforded the proper respect and receive the designation that advanced study and knowledge is usually afforded in other fields.

Patients are left in the middle. Most patients grasp the differences between a physician and a nurse practitioner (or a physician assistant). Where many patients become confused is when the advanced practice nurse is referred to as doctor. As in, “Hello Mr. Green, I’m your nurse, Dr. Blue.”

Nurse practitioners who use the title with patients in care settings makes some physicians apoplectic. Their reaction leaves advanced practice nurses fuming. It leaves me perplexed. Why would any nurse want patients to think he or she was a medical doctor?

Nurses don’t want to be doctors. Advanced practice nurses could have chosen medical school if they wanted to become doctors. Instead, they chose to expand their study of nursing through advanced practice programs such as anesthesia, nurse practitioners, or the rapidly expanding doctorate in nursing practice.

Choosing further study in the nursing profession is a commitment to the nursing model, which emphasizes holistic patient care. Nurses approach their profession in a very different manner than physicians approach theirs and both are valuable and necessary to the overall provision of care in this country. Indeed, given the physician shortage, particularly in rural areas, the only way to meet the country’s needs for primary care is through advanced practice nurses.

So advanced practice nurses are necessary, vital, and supported by the public. Study after study has shown equal, or in some cases better, outcomes in patient care from advanced practice nurses. A study in the northwest last year revealed patients found nurse practitioner care just as good as physician care and the nurse…[read more]

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June 1, 2011

How protocols are taking the decisions away from nurses

Illustration of Florence Nightingale

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Here’s a wonderful article I found on Kevin MD‘s blog that is written by SaraBethRN.  As I read this article, I found myself shaking my head in agreement.  I felt like my own thoughts were printed right there in the article.  I immediately emailed her for permission to reprint here.  I hope you enjoy this article as much as I did.

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by Sarah Beth Cowherd, RN

If you have been at your nursing job for a while, you’ve probably almost forgotten.

Forgotten what it was like to come in to the healthcare system you now work for and realize there are hundreds of new protocols for you to learn and adhere by as a nurse. After years of routine, you now go about your day as if you actually have some choice in the way you give care.

At one point you probably did. I was not around during this age of nursing. The age when we had autonomy. Freedom to practice. Freedom to be innovative.

Today, I am somewhat saddened by the current state of the nursing profession. Don’t get me wrong: I love what I do. I am so thankful for the opportunities set before me.

But whatever happened to “nursing judgment.” Or “nursing decision.”

I can’t tell you how much recently I’ve heard the phrase, “It is hospital policy that…” “You can’t do that, it is protocol that…”

I understand the need for protocols. They help us in the case that something goes wrong and the hospital gets sued. Did the nurse adhere to the protocol? If not, they will be subject to disciplinary action and take the fall. If something goes wrong and there is no protocol, the hospital can say in its defense: “There is now a protocol in place.”

Maybe a less cynical need for protocols: promote and regulate evidenced-based practice among nurses. Evidenced-based practice was developed for a reason: it brings good outcomes and protects the patients.

Even so, to me it seems we are being protocoled to extinction.

When nursing sprang up, before it was considered a profession, nurses had to make due with what they had. They were forced to be innovative. I heard this once in a seminar on preventing pressure ulcers: the reason we turn patients “every two hours” is not from a scientific experiment that proved people won’t get bed sores if they are turned this often. It was from the very roots of nursing itself. When nurses were (how do I put this nicely?) prostitutes and drunks. They would walk down the room and turn all the patients to one side. Then they would sit and have a drink. When they were done with this, about 2 hours later, they would get up and turn everyone the other way. And repeat.

Even today you will read some “protocols” that require nurses to document turning patients every 2 hours. Some recent studies have shown that slightly repositioning (and not completely turning) patients every hour or even every 30 minutes has had better outcomes.

Now if I used this method of preventing pressure ulcers and did not “turn” my patients every two hours, I would be breaking protocol. I would also be forced to “lie” in my repositioning documentation.

This is just one example. I surely don’t mean to argue we should have no protocols in place.

My point is that at times, the red-tape forces nurses into a corner. We may not be creative for fear of disciplinary action.

One more story: While working night shift with a coworker and friend of mine, we had a patient with dementia that kept complaining that air was drifting on her. She was hallucinating. My friend decided to make a tent. A tent of blankets around her bed. The nurse used the IV pump, the bedside light (turned off, of corse), and the sides of the bed. (Keep in mind, this patient was not ambulatory, nor did she have the strength to sit up or attempt to leave the bed.) This was so she felt safe. She felt as though there was no air blowing at her anymore. She finally got some rest for the first time in her hospital stay.

At 6am, my coworker made a point of going into the room to take down the “tent.” Management was coming in. “I’m not trying to get fired.”

Get fired? For making use of what she had? For helping the patient sleep without sedatives? For being innovative and realistic?

We may not be extinct, but we sure are endangered species.

Sarah Beth Cowherd is a nurse who blogs at SaraBethRN.com.

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May 26, 2011

Fighting America’s ‘Other Drug Problem’: Researchers Find Key to Combating Medication Non-Adherence

Conversation between doctor and patient/consumer.

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As a psychiatric nurse, I am quite familiar with the incidence of non-compliance with prescribed medication.  My patients don’t want to take the medications and don’t believe they need them.  Trying to convince them to follow the medication regime is the hardest part of treatment.

I had not really thought about the incidence of med non-compliance with medical patients, but I guess I should have.  When the body is ill, the mind is not operating at optimal levels due to stress.  I also adhere to the concept that all medical patients have a psychological component that should be treated at the same time.

Here is an article that discusses the ways that nurses can deal with this issue.  I like this article because it shows the nurse as the pivotal point in solving the problem.  Please read this article and while you are there, read some of the other articles on this topic.  This site, Science Daily, is one of my favorite sites online.  I hope you enjoy reading there, too.

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ScienceDaily (Nov. 18, 2010)

Medications do not have a chance to fight health problems if they are taken improperly or not taken at all. Non-adherence to medications costs thousands of lives and billions of dollars each year in the United States alone, according to the New England Healthcare Institute. Now, researchers at the University of Missouri have developed an intervention strategy that is three times more effective than previously studied techniques at improving adherence in patients.

Cynthia Russell, associate professor in the MU Sinclair School of Nursing, found that patients who used a Continuous Self-Improvement strategy drastically improved their medication adherence. The strategy focuses on counseling patients to understand how taking medications can fit into their daily routines. Nurses meet with patients and discuss their daily schedules to identify optimal times to take medications and safe places to store their medications.

“Continuous Self-Improvement is a personalized strategy, and the scheduling is different for every patient,” Russell said. “Finding the right place and time for patients to take medications can be as simple as storing the pill bottles in their cars so their medication will be available for them to take during the morning commute to work.”

In the study, kidney transplant patients were given pill bottles with caps that automatically recorded the date and time whenever they were opened. Each month, a nurse reviewed the results in illustrated reports with the patients and discussed how they could improve their adherence. The researchers found significant improvements among patients’ adherence rates. The results indicate the technique is three times more effective than previously studied techniques.

Russell recommends that patients meet with nurses to implement the strategy a few months after medical procedures, when they have returned to their normal routines. During…[read more]

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April 29, 2011

Confessions of a Psych Nurse

Here is an article I found on NurseTogether that absolutely blew me away.  As a psych nurse for over 20 years, I can empathize and sympathize with this author.  She speaks my thoughts.  It is amazing.  I immediately emailed her for permission to repost this article here for you to read and enjoy.  Won’t you let me know how you feel about the things she has to say?  Please click over to her website and read some of her other posts and maybe leave her a comment while you are there.

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A Nurse Confesses:  There is no way to work on a psych ward of a mental hospital and not learn something about life; I have met some of the strangest and most original individuals.  When people find out where I work, and have worked for almost 22 years, their mouths hangs open in awe.  Most of the time the phrase, “I don’t know how you do it” is mentioned, as they shake their heads.

 I confess there are things about working in a mental health institution that I do not like, and there are times when I have to bite my tongue and keep my lips glued together because I become so agitated.  I thought I would list for you my dislikes and explain later what I have learned.  Deep breath…here I go.

 I dislike when someone comes into the hospital just so they can get a check (aka crazy check) when they are clearly healthy but truly too damn lazy to work.

 I dislike when someone is purely and simply mean spirited and uses their diagnosis of being mentally ill as an excuse to cling to.

 I dislike when prisoners come in and break furniture, hurt the staff, share their rude and unintelligent slurs to the staff and demean them, because they have nothing to lose and will be going back to jail.

 I dislike an addicted individual who tries to use their mental illness to be prescribed Benzo to feed their habit, and then becomes demanding when they are told no.

 I dislike restraining someone in the bed.  It makes my heart hurt to see someone, or have to place someone, in that situation.  Even though I know at the time it has to be done – everything else has been exhausted – sometimes it is necessary to protect the staff and the patient. 

 I truly dislike calling a doctor who blows off the fact that the nursing staff have already tried many measures before calling him in the middle of the night for more help, and he refuses it because he doesn’t think it is needed.  I also dislike that he feels he shouldn’t have to come to the unit to observe what is going on, leaving the staff in harm’s way.

 I dislike a doctor who comes to the unit during a high risk situation and hides behind the female staff for protection.  I am not a shield; I am a nurse with a family, just like he has.

 I dislike staff who forget how blessed they are and that they have a home to go home to, when a patient is crying because they are homesick and cannot return to their home.

 I dislike not being able to help a patient understand what he/she is seeing – climbing the walls is part of their illness and not real – but they can clearly can see something there.

 I dislike looking into someone’s eyes and seeing pain, hurt, and loneliness – lost souls that I cannot help.  I really dislike that feeling.

 When a new patient comes onto the unit, I like to learn about who they are, not who the chart says they are.  I want to know where they used to work, where they went to school, how many brothers and sisters they have, and whether they are married and/or have children.  I have found that when I approach a patient as a person, rather than as a patient, they open up and let down the walls that they come in with.  I get to peep inside of their lives for just a moment.  I dislike when staff forget that the people we serve had a life before they arrived on our unit.  They attended school, had some kind of home, they have a mother, father, wife, husband, and/or children.  We have all made some really crappy choices in life – we may not have landed in jail or in a mental hospital, but there were choices made along our path.

 I confess – my psych patients have taught me a lot about life.  I have not always liked working in chaos and in hazardous and dangerous situations, but I have always liked talking to the ones I meet.  They have showed me that we are all one step away from the admission office when life hands us more than we can bear.  They have taught me that just because I cannot see delusions and hallucinations doesn’t mean they are not real.  They have taught me the feelings of real compassion for another human when they cannot help themselves.  They have taught me that being with family is not always the safest place to be.  At times, families hurt family members deeper than a stranger does.

I confess – my life has been changed by a mentally insane person.  Just think…yours could be too.

About the Author: For the first 5 years online, Angela Brooks spent her time in network marketing e-commerce with health products. In the last year, she has followed her passion where she has worked for over 21 years in the same state funded psychiatric hospital, working in a dangerous acute psychiatric ward.

Angela also runs her own company on the side and supports other nurses in how to bring passion into their role at work. Visit www.AngelaBrook.com.

Click here for more information on Angela Brooks.

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April 4, 2011

A New Program for Foot Care Nursing is Available Online

Foot care is not the most glamorous  area of nursing care, but I believe it is one of the building blocks to good health.  If feet are not assessed and cared for properly, all types of physical and emotional issues can arise.

I have always been interested in learning how to do proper foot care and used to follow a particular thread on Allnurses.com’s forum that was about foot care as a business idea for nurses.  I got frustrated when I learned that to become trained and certified, I would need to go the west coast to take classes and then I would need to certify with Wound Care certification.  It seemed like quite a bit of effort and money to maybe be able to make a living as an entrepreneur nurse.

Imagine my surprise and delight when I found this PR in my email.  I am really interested in checking this out, and I thought someone out there also might enjoy this information, so I am posting it here.

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Poor or no foot care can cause infections, amputations even death of Diabetics. Professional Education, LLC, is launching a comprehensive Foot Care Program online for nurses.

This program requires no travel, no time away from home or work and no specific dates or hours of attendance. It can be the prep program for the exam for Certified Foot Care Nurse, a new specialty nurses can add to their career resume.
Austin, TX (Vocus/PRWEB) January 29, 2011

Professional Education, LLC, has a Foot Care Program for RNs that is entirely online. The program brings their knowledge-base in diabetic foot care to where it should be. Regular and monitored foot care is essential for diabetics and those with other chronic illnesses, and a deficiency in this care can be deadly. Diabetes Mellitus is said to be diagnosed in over 11.2% of men and 10.2% of women over 20 years old, according to the American Diabetes Association, but few nursing schools include more than a cursory mention of care of the feet in their curriculums. No nursing text reviewed had over 1.5 pages of text on the feet and many less than one.

A new specialty, Foot Care Nurse (CFCN) now provides the information for nurses to perform appropriate foot care to diabetics and other chronically ill patients. Professional Education’s RN Foot Care Program on http://www.continuing-your-education-online.com is a prep class for the Wound, Ostomy and Continence Nursing Certification Board exam (http://www.wocncb.org) to become a Foot Care Nurse (CFCN®) or can be taken just for added information. This specialty is growing rapidly because of the maturing of our population and the rapid increase in diabetics. A Certificate of Attendance to a prep course and an Internship are required for taking the FCN exam. The exam is taken at nearby test centers.

The trend in attaining specialty certifications makes this Program attractive. Nurses with a specialty certification are paid an average of $12.81 more per hour, according to the RN Magazine’s 2009 Nurse Earnings Survey. Though not defined by specialty, this Survey does indicate that a specialty increases the earning power of RNs.

“Foot Care Nurses are valuable in these days of the high rate of diabetes,” says Suzie Fleak, R.N., Centrum Manager, Columbus, OH. “Foot care is important to maintaining health for the diabetic.” Fleak suggests these specially trained nurses can be utilized in nursing homes, wound care facilities, critical and emergency care units; in community and home health nursing, medical and podiatry offices and many other locations where health care is provided.

Professional Education, LLC, launched January 2011, will be offering quality courses within a wide array of professional specialties and strives for excellence in the programs. All courses will be on-line only, though when needed by the specialty, Internships will be designed for that purpose. All courses are written by experts in the specialty. For questions and if you know of courses that would meet our site goals, see http://www.continuing-your-education-online.com or contact us at 512-763-9340.

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March 18, 2011

When Nurse Staffing Drops, Mortality Rates Rise: Study

Filed under: Nursing — Shirley @ 4:12 am
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Here’s an article I found in my email this morning.  This article simply states what we nurses have always known.  If we don’t have time to see our patient due to staffing shortages, then we don’t have time to do nursing for our patients.

People today don’t come into the hospital for a “rest cure” like they did 50 years ago.  Today you need to really be sick or at death’s door figuratively (or literally for ER and ICU) to even be admitted to a hospital.  When you have critically ill patients to care for, there is a minimal amount of time involved to simply provide basic care and assessment; but when you have 7 or 8 critically ill patients how much time do you think you get to spend with each one during a standard 8 hour shift.  Let’s not even consider charting, answering the phones, talking to doctors and pharmacy, getting lab results, etc.  Let’s just consider time to look at and observe your patient; time to interact with the patient and the family to gather pertinent information about the patient’s condition prior to the current crisis.

Since I am a psychiatric nurse, you may think that this all does not apply.  However, today for a person to actually be admitted to a psychiatric facility, they MUST be in imminent danger to self or others.  In plain English, that means they actively want to kill themselves or plan to hurt/maim/kill someone else.  When you have 8 or 9 of these types of patients to observe and medicate as well as a milieu to manage to maintain everyone’s safety because all of these patients are up walking around in the day area,  there is very little time to actually spend working with your patients.

Here is the article I got this morning from the ANA.  The article is from the Health Day website.  Interesting, don’t you think?

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Experts say finding shows clear link to patient safety

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, March 16 (HealthDay News) — When nurse staffing levels fell below target levels in a large hospital, more patients died, a new study discovered.

The finding may provide guidance in an era of nursing shortages and cost-cutting, in that the focus should shift from cost to patient safety, said the authors of the research, appearing in the March 17 issue of the New England Journal of Medicine.

“Hospitals need to know what their nursing needs are for their patients, and they need to bring staffing into line,” said study senior author Jack Needleman, a professor of health services at the School of Public Health of the University of California Los Angeles.

“Patients are entitled to be safe in the hospital and to have care delivered reliably and to have nurses with enough time to make sure they aren’t developing avoidable complications with permanent consequences,” Needleman said.

Previous research has suggested that this might be the case, but many of those studies were dismissed in part because of methodology flaws.

“People had thought maybe [adverse consequences] were due to something else, maybe the quality of the nurses, quality of the doctors, technology, equipment or the hospital doesn’t have a commitment to quality,” Needleman explained.

For this study, the authors looked at almost 200,000 admissions and about 177,000 nursing shifts at 43 patient units at one hospital that generally had high staffing targets.

Presumably, different areas of the hospital had the same quality of nurses, doctors, technology and equipment, thus eliminating these factors as the source of problems.

Units were considered properly staffed if nursing staffing fell within eight hours of the target level.

When units were understaffed, patient mortality increased by 2 percent. On average, a patient stayed in the hospital for three shifts and when they were all understaffed, mortality rose by 6 percent.

And when nurses had to work harder because of high patient turnover on their unit, the mortality risk increased by 4 percent.

“A telling outcome is that they looked at a hospital that really had pretty good staffing levels and they still found that there was a difference,” said Sharon Wilkerson, dean of the Texas A&M Health Science Center College of Nursing in Bryan. “When I think about the number of hospitals that do not maintain good staffing levels, either because they can’t find the nurses or maybe they’re rural or they’re just aren’t as many people they can hire, that’s even more frightening.”

The authors believe the findings…[click here to read the rest]

 

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