In the healthcare system, Core Measure sets are used to measure quality care. It consists of pneumonia, heart attack, immunizations, emergency department, sepsis, for infection prevention, and others. Evidence-based treatments are used to prevent occurrences using structures, processes, and outcomes. In nursing, they have adopted a similar method of performance measures, known as nursing-sensitive indicators. It includes falls, and this indicator is implemented in each unit of the hospital and managed by the manager and educator along with others like CAUTI and CALBSI. According to the American Hospital Association article (2015) “Falls with Injury,” Patient falls-an unplanned descent to the floor with or without injury to the patient affects between 700,000 and 1,000,000 patients each year.”
Point of care testing (POCT) refers to laboratory testing that occurs close to the patient rather than in a central laboratory. POCT is usually performed by non-laboratory trained individuals such as nurses, physicians, respiratory therapists, percussionist’s, anesthesia assistants, midwives and paramedics . In recent years, these assays have been increasingly carried out at sites of patient care, such as doctor’s offices, emergency rooms, and even at home. This trend allows for rapid estimates of the state or progress of an illness . POCT is mainly characterized by proximity to the patient, quantitative or semi-quantitative single measurements, short turnaround time, no sample preparation, no pipetting, use of pre-made reagents, user-friendly dedicated analytical instruments and instant, result deduced therapeutic action . In recent years, POCT has gained ground worldwide. In advanced healthcare
Ms. Sunshine had blood work sent known as cardiac markers. The labs individually are creatine phosphokinase (CPK), CPK-MB (a type of CPK specific to myocardium), and troponin.
The purpose of arterial pressure and the pulse lab is to determine the effect of posture and exercise on systolic and diastolic pressure and the heart rate. And also in order to find the differences in the reading taken under these condition compares to the baseline reading. The Sphygmomanometer and stethoscope are used to measure the systolic and diastolic blood pressure, counting the beat on the radial artery will give the reading for pulse rate and by using the lab scribe software and IWX214, the blood pressure will be measured. In the heart, the aorta and the carotid arteries have baroreceptors and the chemoreceptors that identify the changes in arterial pressure and the changes in
Troponin is present in heart muscle cells. If damage is done to these cells, it releases troponin into the bloodstream. The blood level of troponin, during a heart attack, increases within 3-12 hours from the onset of chest pain. It peaks between 24-48 hours and returns to a normal level over 5-14 days (Koutoukidis, Stainton & Hughson 2013, p. 506). The indicators include acute myocardial infarction, severe pulmonary embolism causing acute right heart overload, heart failure, and myocarditis. The normal value of Troponin I is <20
Hospitals regularly measure patient care, which is defined as any health care service provided to an individual. It is measured in different ways according to the type of health care service provided. However, there are basic principles that guide how all patient hospital care is measured.
The College of American Pathologists or CAP is the accrediting organization for laboratory and testing personnel. CAP’s “accreditation process is so thorough, the Joint Commission [and CMS] accepts …their standards” in place of conducting their own survey of the hospital’s laboratory and personnel (Gartee, 2011, p. 47). This is because of the guidelines they follow to maintain their integrity and to remain the industry standard. In recent years, the “CAP [has] developed new check list” for continued improvements. Additionally, they are continuing to vet the requirements for the new next-generation sequencing or NGC-based test that is speeding laboratory procedures. So much so that the recent adoption of the new technology for clinical testing” was done prior to the new standards being approved (Aziz, et.al. 2015, p. 481).
An integration of care study was conducted by a Doctor of Behavioral Health Intern at Michael R. Zent (MRZ)Healthcare Clinic in Phoenix, Arizona. MRZ is a reverse co-located integrated medical and behavioral clinic that provides services to about 4000 children and 4000 adults annually. MRZ provides laboratory, pharmacy, behavioral and physical health services together under one roof. The clinic utilizes an integrated electronic health record to document the treatment of members. The focus of the integration of care study was to understand and assess the barriers and challenges of the integration of care methodology at MRZ.
This test is often used to see if you have been exposed to viruses or other infectious substances. It is frequently used to screen for present or past infections.
Often times the chest pain and symptoms people are experiencing are benign, in utilizing the POC testing patients people can be quickly assessed for cardiac markers and if negative will result unnecessary precautionary medication utilization, decrease in unnecessary overnight observation, shortened length of stay in the ED as well as reduction in patient anxiety waiting for lengthy lab results (Noyan, 2013).
30). According to Brunstein (2016), individual tests can be moved to a patient’s bedside or in other less formal settings to provide faster diagnosis, allowing for quicker response times when medical interventions are needed (p. 30). Bedside testing uses a method called point-of-care testing (POCT) and presents both new possibilities as well as challenges (Brunstein, 2016, p. 30). Brunstein (2016) points out some of the challenges are decreased sensitivity, specificity, or sometimes both, especially when compared to the testing that is done in the core lab (p.30). However, POCT can prove to be advantageous because of reduced response times for medical interventions. POCT with moderate sensitivity and high specificity have proven to be convenient, cost effective first-line screening tools (Brunstein, 2016, p. 30). Molecular POCT has positive implications for the future but there are some limitations. POCT used for molecular diagnosis (Madix) are limited to only
The reading that was most interesting to this writer was the Point of Care article written by M.C. LaFerney (2017). He discusses an issue which is very relevant for nursing and nurse leadership. The article elaborates on a nurse reporting to a psychiatric mental health clinical nurse specialist (PMHCNS-BC) that one of her patients is depressed and he should be evaluated. There was no supporting evidence provided by the nurse for the referral. In this writer’s opinion the article respectfully develops and distinguishes an ongoing practice by many nurses; hastily diagnosing mental health issues with either lacking, or no evidence. The caveat is that readers understand the difference between nursing diagnosis and medical diagnosis within
The preanalytical errors increases health care costs and decreases the patient satisfaction. The laboratory errors that happen at any stage of the total testing process have influence on quality of laboratory services. Any errors that happen during this total testing process will affect the patient care that also includes unnecessary recollection of samples, delay in reporting, misdiagnosis and treatment by the clinician. Although the errors can happen at any stage of the total testing process, preanalytical errors accounts for highest percentage (70%). The consequences associated with analytical errors are significantly reduced by the use of modern laboratory instruments. But pre analytical phase is still prone to more errors due to its complexity and different stages that involved within and outside laboratory. The inaccurate reporting of results due to preanalytical errors leads to unnecessary investigations and creating an additional burden to the healthcare system (Kaushik, & Green, 2014). According to Green (2013) the healthcare economist created a model to quantify the costs associated with laboratory errors and poor sample quality. It is based on operating costs, number of beds, test volume, number of rejected samples, instrument problems and the frequency of inaccurate results reported by laboratory and their impacts. As per this model
During my experience in clinical placement, I was allocated a female patient in the rehabilitation ward who was of German descent. Although this patient was from another culture, growing up in Australia allowed her to have a fluency in understanding and communicating with the English language. For the purpose of this reflective essay and patient confidentiality, I will refer to the patient through a pseudonym when describing the episode of care I experienced when looking after her.
CARE is a communication and relationship education primary intervention social cognitive model aimed at developing the self-efficacy of adolescents to verbally respond to sexual coercion. CARE encompasses three components: a CARE pedagogy, a CARE training course and a CARE VW. The following sections discusses each component in more detail.