The Implications Of Using ALOS

A visit to the emergency department (ED) is usually associated with negative thoughts by most people. It creates preconceived images of overcrowded waiting rooms and routine long waits for treatment (Jarousse, 2011). From 1996 to 2006, ED visits increased annually from 90.3 million to 119.2 million (32% increase). During this same time period, the number of EDs has declined by 186 facilities creating the age old lower supply and greater demand concept (Crane & Noon, 2011). There are many contributing factors that have led to an increase in ED visits. A few of these key drivers include lack of primary care access, rising of the uninsured population, dwindling mental health services, and the growing elderly

costs by the total annual number of inpatient days and outpatient visits to obtain a per episode

Immediately life threatening A patient with chest pain, severe blood loss, MVA, sepsis. These types of patient are prompt to deteriorate, and their life could be at risk if not treated within 10 min of arrival in ED. (Basnet, Bhandari and Moore, 2012)

The study revealed several issues in this department. Voluntary emergency patients have to wait extended periods of time before being transferred to the appropriate department. The majority of those who have to wait are those seeking mental health assistance. Keeping people in the emergency department longer than necessary cause operational costs skyrocket, and worse, keeps the needs of patients from properly being met.

a patient who is admitted to the hospital that requires to stay 1 or more days for treatment.

In regards to patient outcomes following Code Blue and MET calls (as a percentage), the change from the provided data indicates that the implementation of the ‘EARLY SAVE’ program has had a positive effect on the number of patients remaining on ward. The change in percentages of the variables ‘Could not be resuscitated (died)’ and ‘Transferred to ICU’ has been allocated to the fourth variable ‘Remained on ward’, resulting in an increase in its percentage. An percentage increase in ‘Remained on ward’, and a decrease in ‘Could not be resuscitated (died)’ and ‘Transferred to ICU’ means that more patients were able to be saved, which is a positive indication (Reinhart et al., 2012).

Every day in this country, millions of people enter the hospital for a variety of reasons with the expectation of receiving the best of care. In the vast majority of hospital admits, the patient is treated and discharged without incidence. However, this is not the case for the estimated 210,000-400,000 annual patient deaths

The current length of stay in a skilled setting is based on payer source. For example, a straight Medicare patient has the skilled benefits that can occur for 100 days, whereas a patient with a managed plan like Humana have weekly progress reports that are sent to a case manager, and that case manager dictates their length of stay. The current aim of my Genesis facility is to continue to work on rehospitalization rates. The due diligence that is provided to the patients is practiced by setting up in home therapy and home health care as an added measure to prevent rehospitalizations. Appendix A provides a visual road

Safe nursing ratios provide better outcomes for patients and provide better working conditions for nursing staff. Unsafe nursing to patient ratios have detrimental and negative outcomes in the nursing care that patients can receive in the hospital. For example, medications that are administered to patients late can alter their drug administration schedule. The late administration of cardiac drugs can be detrimental to patients’ well-being because this can cause a failure in maintaining the drugs therapeutic serum levels and consequently increasing the likelihood of arrhythmias. High patient to nurse ratios can also cause nurse burnout. Nurse burnout is precipitated by the increased physical and emotional exhaustion from being assigned too many patients depending on the type of floor that one is working. This causes nursing staff to leaves the nursing field due to the undue stress and look for positions that aren’t as stressful. This will only contribute to the nursing shortage. Patient hospital stays can also be effected due to the number of days that a patient stays in the hospital. This leads to an extended number of days in the hospital which can cause a loss of money that insurances would not agree to pay. The safety of the patients need to be a nurse’s priority and this can be a great cause of concern with an unsafe number of patients being cared for by the nurse. As nurse timing becomes a priority, it becomes important to be able to take care of each patient that is

Healthcare in the United States is changing which has given rise to new hurdles that must be overcome. One of the issues that we are currently facing in many tertiary facilities is the need for set criteria involving intensive care unit admissions and discharges. Throughout the country the total number of intensive care unit (ICU) beds are on the rise, but the current supply still outnumbers the demand (Cognet & Coyer, 2014). The cost of staying in an ICU is continuing to increase with technology, and there are limitations that insurance companies and the government have set forth to the number of days a patient can reside there dependent upon his diagnosis and condition. Intensive care units will continue to undergo strain due to high census, and decisions to discharge patients will be effected (Wagner, Gabler, Ratcliffe, Brown, Strom, & Halpern, 2013). Typically, the decision to have a patient occupy an ICU bed is based upon whether or not they are sick enough to be there or if they are well enough to be discharged to a progressive care unit (PCU) or medical surgical unit (Meyer, 2003). A progressive care unit is a step down from an ICU, but has stricter criteria for admission than a medical surgical unit based upon the patients medical status. Not all facilities offer a PCU, but the need for this level of care is continuing to rise with the number of ICU admissions increasing. Standardized guidelines for patient placement in

looking at mortality rates in patients seeking emergency care conclude that the rate of death is substantially higher during times of crowding (Richardson, 2006, p. 213).

patient is no longer able to attend a hospital that meets their needs, the lives of the individual’s

inflow of patients is higher than the available beds. You are treating an elderly man who is breathless and cyanosed. While you assess whether he has chronic obstructive pulmonary disease or heart failure, he becomes drowsy and starts gasping. You quickly intubate him with some difficulty, prolonging his period of hypoxia, and put him on ventilator support. You then get a phone call from a senior consultant in the hospital that an important social activist is about to arrive with chest pain and will need to be admitted. You are directed to

ALK (Anaplastic lymphoma kinas) is part of the leukocyte kinase receptor superfamily. It is made up of three different domains: the extracellular domain holding the N-terminal region and the ligand-binding site for pleitroplin,midkine, the transmembrane and juxtamembrane are holding thee binding site for phosphotyrosine-dependent and finally the intracellular tyrosine domain has three phosphorylation sites and the C-terminal sites for phospholipase C-gamma and Src homology 2 domain containing SHC1. ALK is responsible for the regulation of cellular growth and when mutated, translocated or overexpressed , it can lead to neoplastic transformation2. To slow down the neaoplastic transformation for becoming a cancer, many drugs had been designed

Upon arrival a patient should have been made aware about a delay therefore he/she would not get inpatient. The appointment itself should not be rushed. A health proffessional should have explained everything in a clear and precise manner giving patient the opportunity to voice any concern or ask any additional questions. In regards to the appointment itself, the