Management Plan For Patients With Cancer

I have assisted clinical fellows and house officers to insert a cannula into a patient’s vein. I have assisted the physiotherapist

5. Poulin,P., et al.(2014) Preoperative Skin Antiseptics for preventing surgical site infections: What to do?

The second week of my preceptorship brought many new experiences for me, and I can honestly say that each day I spend with my preceptor is better than the last. This week I focused on time management of a full patient load with continued documentation practice as well as admission and discharge procedures. I’ve had brief experiences in my past rotations assisting with discharge teaching and admission assessments however I have never been able to fully take charge and complete the process from start to finish, so this was a great learning opportunity for me.

1. Emergency department doctor enters orders for a consulting doctor to come and look at

Over the course of the semester I participated in numerous meetings within the administrative and clinical departments, alongside the CEO, Vice President, interdisciplinary teams, nurses, and nurse’s assistant, to discuss the future of healthcare and the importance of quality of care for the patients. In addition, I completed a prevalent amount

Stroke is noted by Lee, Shafe and Cowie (2011) to be a major cause of both morbidity and mortality in the United Kingdom. It is estimated that close to 110,000 incidences of stroke occur in England annually (National Audit Office,2004) with recent studies reporting that the rate of incidence ranges between 1.36/1000 per year (Hippisley-Cox , Pringle , Ryan, 2004) and 1.62/100 per year between 2002 and 2004 (Rothwell et al,2004). Even though cases of deaths from stroke has decreased in the United Kingdom over the last forty years, stoke accounted to close to 46500 deaths in Wales and England in 2008 (accounted for 9 percent of all death cases (Lawlor et al,2002; Office for National Statistics,2008). The current United Kingdom health policy places a lot of emphasis on the reduction of stroke (Department of Health,2007,2008). Key to realizing this is the importance and need for better management of the vascular risk factors such as hypertension, high cholesterol, obesity, diabetes and atrial fibrillation. In this paper, we present an essay based on the assessment of care of an elderly patient suffering from six different pathologies with stroke (non-haemorrhagic) being our pathology of choice. A rationale for this choice is provided followed with the underlying pathophysiology of the chosen aspect of care and finally an evidenced based analysis of the nursing interventions required for the selected aspect of care.

In my current position as a registered nurse, I have identified improving patient compliance and stroke rehabilitation as an important phenomenon of interest. While researching cerebrovascular accident (CVA) articles, I have a strong desire to enter the field of neuroscience because I feel that there is a great need for reform in stroke awareness and treatment care in the cerebrovascular patients across the nation. In today’s society, Advanced Practice Nurses (APN) are not viewed as a rare commodity but as a representative to physicians across the nation, assisting in many health care needs. APNs are thoroughly accepted by both health care organizations and consumers and serve a vital role in the population overall well-being. Additionally, APNs will become essential as more individuals gain access to broader services through health care reform efforts, and they will serve as attributing members of a flourishing healthcare system. As I transition into my role as an APN, I plan to focus my efforts on managing and coordinating care for the clinically complex neurological and neurosurgical population. This paper will highlight the importance of following stroke guidelines presented by Joint Commission to help increase the health of the population through improved patient compliance and stroke rehabilitation.

The population clearly applies to all health professionals within the multidisciplinary team which may help guide clinicians in developing the best evidence practice possible with stroke patients. The CPG highlights some of the roles the listed health professions may undertake with patient and benefits of collaborating in an inter-professional environment.

When D.B was asked about patient care technologies and how it improved the care of patients’ we both concurred that smart technologies infusion pumps; EMAR; pharmacy loads the medication in the “accu-dose” (medication equipment) and a get well network for the interaction of patient care, is very crucial to safety of our patients’ and the way care is delivered. She showed me a picture of what the patients’ communication entailed. This patient flow board is in the rooms of every patient and they can request services by scheduling the lift team rounds and transportation. During this question, I had to ask D.B., what is a lift team? She replied that, “we have a special team consist of males only, whose responsibilities are to assist the nurses

Individual approaches have also been shown to be effective in reducing the burden of disease both in regards to secondary prevention and improving outcomes following the event. Individual approaches are targeted at the clinical level and focus on ensuring that patients receive evidence-based care to optimally reduce the mortality and morbidity consequences of stroke. Secondary prevention targets 'high-risk' individuals following their stroke event whereby tailored strategies can be used to reduce the risk of recurrent stroke and other cardiovascular events. This can be particularly effective as greater adherence to secondary prevention is more likely following a major health event. In theory, targeted approaches should be an efficient, straightforward and cost-effective means of addressing the burden of

The current process leaves a large gap in service by delaying the transfer of the patient due to the above contributing factors. Patient safety is a number one priority of our facility, each missed opportunity for a referral from a regional facility affects patient safety by delaying the necessary treatment. Alleviating the contributing factors increases the likelihood of further referrals. Each patient that enters our door generates an estimated revenue of 5000- 25,000 dollars, so each missed opportunity for transfer affects the bottom line which in turn affects each department and the level of care we can provide to patients.

It has been noted that up to 67% of inpatient admissions from the emergency department are delayed because of multiple consultations (Tashandy, Gazzaz, Farooq, & Dhafar, 2008). This delay is further compounded by the communication and re-consultation time lags. The result is longer ED waits times and treatment delays (Hamm, 2014). The refusal of admissions without a direct patient evaluation is an institutional risk as well. The decision to admit to an inpatient service made by a provider based solely on a phone call may lead to unrecognized conditions. This practice places patients at risk.

There have been many cases of clients not receiving medical care due to lack of transportation. Our appointment coordinator has stated that 20% of our patients cancel their appointments due to lack of transportation. They have tried using vehicles designated by their insurance company, but experience many difficulties. In order for a client’s

Providing patients and families with information about their diagnosis and plan for follow-up is an important part of discharge from the emergency department. A visit to the emergency department can be a frightening and unnerving experience, leaving patients unable to recall their treatment while there and with difficulty understanding what was told to them regarding home care.

Thank you for your feedback on our stroke measure performance. I would like to respond to your request for a performance improvement plan for the Cornwall campus for 2015. I have reviewed our data submission for the 2015 calendar year for the Cornwall campus of the St. Luke’s Cornwall Hospital. It found in the measures IV t-PA Arrive by 2 Hour, Treat by 3 Hour and Anticoagulation for AFib/Aflutter that our percentage was 0% for the reason that we did not have any patients that met the criteria for the denominator. Thus, the performance should have been identified as N/A and not 0%,