(Harrison,
(Harrison,
The purpose of this study is to evaluate the impact of interventions designed to reduce hospital admissions or length of stay amongst frail older people. Databases that were used to retrieve the studies are: PubMed / Medline, PsycINFO, CINAHL, BioMed Central, Kings Fund library. Studies were limited to publications from period 2007- present. Researchers classified interventions into those which aimed to prevent admission, interventions in hospital, and those which aimed to support early discharge. Total of 514 studies were identified and out of those 48 studies were studied for full review.…
“A patient-centered medical home provides patient-centered, comprehensive, and coordinated care that supports patient self care; offers superb access to care; and employs a systems-based approach to quality and safety (Taylor, Lake, Nysenbaum, Peterson, & Meyers, 2011).” After experiencing a medical emergency, the patient was initially hospitalized. Once stabilized to the point that she no longer needed hospitalization, she was transferred to a SNF for rehabilitation. Following rehab, arrangements were made amongst family members and a case manager to transition Heidi into a nursing home to assist with ADLs and IADLs because she was too severely disabled to return home. Upon significant improvement, Heidi was transitioned back home and had continued care with a home health agency providing physical therapy and a homemaker. All of these services were very well coordinated and supported Heidi’s transition to self care.…
Dr. Ratner’s speech made me realize the importance of one of one care with each one of your patients. It is impactful to learn about each patient on a personal level beyond what any chart can tell the nurse or doctor in order to advocate, care for and create a plan of…
Readmissions were highest among Medicare patients at more than 55 percent. Follow-up appointments, medications, and other appropriate actions are taken to reduce readmissions. Emory’s ongoing quality improvement efforts include several programs to ensure that when their patients are discharged, they have a clear understanding of what they need to do, how to get medical help if needed and when to see their physicians in follow up. Heart failure readmission rates. Findings suggest that the nurse-led evidence-based HF education program improved self-care behaviors and decreased 30-day readmissions.…
I would like to highly recommend Therese Breza R.N. for the Wound Ostomy Continence Nurse Certification Course at Rutgers University. Therese has been employed by Seniors in Place for two years as a nursing supervisor and has made a positive and strong impression on me and our clients. During her time here, I have found Therese’s assessment skills to be strong, allowing for appropriate customization of our clients plan of care. Often, my nurses are the first health professionals our clients see after being discharged from the hospital or rehab.…
During my time at Lahey, I cared for patients suffering from a myriad of cardiac conditions. This included caring for patients recovering from the treatment of AV blocks, atrial fibrillation, congestive heart failure, acute coronary artery syndrome, and post-surgical repair of the coronary arteries. In completing this preceptorship, I learned how to analyze EKG strips, perform tracheostomy care, initiate tube feedings, and perform dressing changes, etc.…
We undertook a clinical study approved by the local Research Ethics Committee1 of 200 patients in a postoperative ward of the Cancer Centre, Oxford University Hospitals NHS Trust, Oxford, U.K. Patients were discharged to the ward following upper-gastrointestinal (GI) cancer surgery. This group of patients was selected for our study because of the high incidence (up to 20%) of postsurgical complications, whereby patients can deteriorate physiologically, resulting in adverse outcomes such as readmission to the intensive care unit (ICU) or death. Readmission to the ICU is prolonged and the mortality rate of such patients is high. These adverse events may occur when the physiological condition of the patient is not recognized or acted upon early…
Every day you meet patients of various backgrounds who create a positive impression that can last for a lifetime. Half of my childhood was spent observing my mother take care of my sick grandmother who was suffering from liver cirrhosis. As I grew up watching my mother nurse my sick grandmother, the value of compassion, love, and respect for the sick has been instilled in me. Many people in America are lacking adequate health-care even with Medicaid and Medicare. Due to lack of government funding, the quality of care is debased while the quantity of patients seen per day is given greater priority.…
We use our highly successful Care Transition Program to help reduce hospital readmission rates. When we receive a referral from you for home health services, a warm transfer visit is made to the patient before they transfer to home or facility. A hospital readmission risk assessment is completed and the care team is alerted to the triggers which may result in readmission as well as explaining to the patient what to expect from the home health experience. Please see the attached fact sheet for more information. Our Service area includes; Winchester City, Frederick, Clark, Warren and Shenandoah Counties.…
Avoidable readmissions come at a great cost to patients/residents, healthcare providers, and taxpayers, a $25 billion cost to be exact. This is the estimated amount that avoidable readmissions cost the nation on a yearly basis and is one of the largest contributors to the enormous growth in national health care costs. Readmissions are the result of several difference aspects from incomplete treatment, poor post-acute care, lack of coordination in discharge planning, or even the unavailability of social supports. Recently the Center for Medicare and Medicaid (CMS) began penalizing hospitals for avoidable readmissions as part of the hospital readmission reduction program supported by the Affordable Care Act (ACA). Now that these penalties have become the “law of the land”, CMS is moving onto the next phase of in care continuum, post-acute-care, specifically skilled nursing facilities (SNFs).…
Although FNPs fill an important role in our health care system, focusing my studies and practice on gerontology will allow me to better provide for the older adult population. My first semester clinical site was on a medical-surgical floor in Medical Center North, and most of the patients on that unit are older adults who were from surrounding rural counties. Throughout this rotation, my patients taught me the immense difficulty of managing chronic disease on top of working, parenting, and maintaining quality of life, especially when providers are inaccessible. Meeting with residents at Cumberland View Towers for Community Heath has re-enforced the complexity associated with primary care in older adults. As health issues increase in complexity and resources decrease, it is difficult for patients to…
And, at the same time, “Inquiry into and curiosity about aging is as old as curiosity about life and death itself” (Ebersole & Hess, 2016, p. 19). As the number of the older population increases, nurses have to ensure that the evolving needs of the elderly are considered in the provision of their care. “Given the ageing … population, nurses will need to spend more of their time caring for older people. This constitutes a potential problem for the provision of health care to older patients if nurses’ attitudes towards working with this patient group have an impact on the type and quality of care provided” (McKinlay & Cowan, 2003, p. 299). Thus, the passage of the Affordable Care Act of 2010 had underscored the new roles of nurses not only in the acute care setting, but more so in the community (Ebersole & Hess, 2016).…
4. Supporting argumentation for the proposed changes The barriers to action There used to be significant resistance and minimal incentive for preventing readmission in many layers of health care. It is now true that there has been more awareness and attention to the problems and issues regarding readmission to acute-care hospital, regardless of location of care such as ambulatory care or SNF. Therefore, it is also true that numerous researches and papers published to solve this issue by various interventions and programs reflect the significance of problems and emergent attention, especially administrative and management level that is more conscious about the potential financial impact from readmissions.…
Lack of patient compliance with health and medicine regimen cost the United States healthcare system billions of dollars contributing to rising healthcare costs (McGuire & Iuga, 2014, p. 35). This behavior translates to unscheduled outpatient visits such as emergency room utilization and high inpatient readmission rates. Patients with chronic diseases such as Congestive Heart Failure (CHF), Asthma, Coronary Artery Disease (CAD), and Chronic Obstructive Pulmonary Disease (COPD) experience high readmission rates due to poor compliance with plan of care, which takes away critical healthcare resources for patients with acute health issues (Mahoney, Ansell, Fleming, & Butterworth, 2008, p. 2). The high readmission rate often results in scheduled…
It is important to assess and identify the gaps of knowledge deficits regarding the medication compliance, cardiac diet, enough rest, and dietary supplement. After the gaps of knowledge deficits are identified, specific teaching should be provided to Mrs. Franklin-Jones. For example, since Mrs. Franklin-Jones concerns that she forgot to take medications sometimes, the nurse should instruct her to use a weekly medication divider box and place the box on the dinner table, which will reminder to take the medication whenever she is ready to have a meal. Another good example of teaching for Mrs. Franklin-Jones is to provide print-outs for cardiac diet and research of benefits and risks of drinking bush tea. The nurse should provide comprehensive education regarding the identified gap of knowledge deficits during the discharge…