Student Nurse Laura

Orem – "creative effort of one human being to help another human being."

Body Mass Index

Posted by Laura on February 28, 2015

Body Mass Index




At work we are looking at BMI in connection with Medicare Incentives. I created these charts using the National Institute of Health’s BMI charts. Thought I would share here.

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Healthcare Statistics

Posted by Laura on February 26, 2015

Formulas of Occupancy

BED OCCUPANCY PERCENTAGE – Total number of inpatient days for a given period x 100, divided by, Available beds x Number of days in the period

BASSINET OCCUPANCY PERCENTAGE – Daily NB census (IP service days), divided by, NB Bassinet Count for that day (x100)

DIRECT BED TURNOVER RATE – Total number of discharges for a period, divided by, Average bed count for the same period

INDIRECT BED TURNOVER RATE – Percentage of occupancy x Days in the period x100, divided by, Average length of stay

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Healthcare Statistics

Posted by Laura on February 24, 2015

Terms of Percentage of Occupancy

INPATIENT BED COUNT – The number of available hospital inpatient beds both occupied and vacant on any given day


TOTAL BED COUNT DAYS – Sum of inpatient bed count days for each of the days in a period

NEWBORN BASSINET COUNT – The number of available newborn bassinets, both occupied and vacant on any given day

BED COUNT DAYS – Counts the presence of one inpatient bed (occupied or vacant) that is set up and staffed for use in one 24-hour period

NEWBORN BASSINET COUNT DAYS – Is the number of available hospital bassinets both occupied and vacant, on any given day

INPATIENT BED COUNT DAY – One inpatient bed set up and staffed for use and either occupied or vacant, during one 24 hour period

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Another Name is…

Posted by Laura on February 22, 2015

Kassebaum-Kennedy Law

Public Law 104-191  1996

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What is another name for

Posted by Laura on February 21, 2015

Health Insurance Portability and Accountability Act of 1996  ????

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Reflective Journaling

Posted by Laura on February 19, 2015


I have to do reflective journaling with an online digital clinical program. After I complete the day’s activities, I need to write in my reflective journal. My instructor has access to this and wants us to include specific areas for improvement, what we learned and how we can apply it in our practice. She wants to know the moments of


LEARN is an acronym to help guide my journaling. I’ll be using these five steps: Look back, Elaborate and describe, Analyze the outcome, Revising my approach, and New approach.

L – Looking back

  • Recall the experience. Reflecting shortly after the experience will help.
  • Describe what transpired. Who was involved?

E – Elaborate and describing

  • What subjective and objective factors contributed to the experience?
  • What did I say or do? What were my actions? What bothered me? What didn’t feel right?

A – Analyze the outcome

  • Was this experience a positive or negative experience for me and why?
  • Did I make assumptions? Why did I intervene as I did? What other choices did I have? What happened as a result of my actions?
  • What internal and/or external factors influenced me?

R – Revising my approach

  • As a result, what will I continue to use in practice, what am I satisfied with, and could I have done differently?
  • Was there other choices? What do I need to do better? What do I know now, that I did not know before?

N – New approach

  • Try the revision out. Do I need to change my practice, gain more knowledge? What did I learn from this experience? What will I be able to do now that I could not do before? How will I find opportunities to include my new point of view into my clinical practice? How will I evaluate the success?

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Criteria of expected outcomes can be done SMART

Posted by Laura on February 17, 2015

S – Specific

M – Measurable

A – Achievable

R – Realistic

T – Time phased

Gina is to obtain clear lung fields by using her medication as prescribed. Her goal will be obtained when her lungs are not wheezing, but have normal lung sounds upon auscultation at end of shift

CDC. SMARTobjectives. Retrieved from:

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Patient Census

Posted by Laura on February 15, 2015

Patient Census are important for budgeting resources, but there is a difference in terms. 

Census Taking

  • Daily inpatient census: The number of inpatients present at the census-taking time. Add any inpatients who were both admitted after the previous census-taking time and discharged before the next census-taking time
  • Inpatient census: The number of inpatients present in a healthcare facility at one consistant given time

Service Days

  • Inpatient service day: A unit of measure equivalent to the services received by one patient during one 24-hour period. Does not matter if they weren’t there for the full 24 hrs.
  • Total inpatient service days: The sum of all inpatient service days for each of the days during a specified period of time, such as for the month.


Upcoming Math

Calculation of Inpatient Service Days

Calculation of Transfers

Recapitulation of Census Data

Average Daily Inpatient Census

Average Daily Newborn Census

Average Daily Inpatient Census for a Patient Care Unit


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Evidence for Trail

Posted by Laura on February 13, 2015


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Posted by Laura on February 11, 2015


Current use under the AHIMA now states:

Consent is permission for treatment, payment, or healthcare operations


Authorization is permission granted by the patient or the patient’s representative to release information for reasons other than treatment, payment, or healthcare operations


Authorization to disclose information - allows healthcare facility to verbally disclose or send health information to other organizations (the patient or legal rep has signed the authorization).


Sayles, N. (2013). Health Information Management Technology: An Applied Approach. Current edition. Chicago, IL. American Health Information Management Association.


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Federally Funded CARE, Federally Funded AID

Posted by Laura on February 9, 2015

medicare medicaid


info retrieved from:

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Basic Concepts in Healthcare Information Management

Posted by Laura on February 7, 2015


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Leading Causes of Death in the US

Posted by Laura on February 6, 2015

Have you thought about the leading causes of death in the US?

Back in 2009, the 8th leading cause of death was due to medical errors. An average of 195,000 deaths annually in the US (Watson, 2009). According the Joint Commission, the near-miss sentinel events such as catching medication errors before administration to patients, are non-reviewable sentinel events. Meds given, which don’t cause death or loss of function, and unsuccessful suicide attempts are a few others. The Joint Commission requires a root cause analysis and action plan for reviewable events. Some of these areas are the paralysis, coma, death, or major permanent loss of function (Watson, 2009). If we can practice better communication skills, we can help make a change in the a leading cause of death in the US.

Currently the World Health Organization shows, in order,  the top 15 causes of death in US:

Heart Disease



Lung Disease






Blood Poisonings


Liver Disease




Data Retrieved from WHO, and

Watson, D. (2009). Sentinel events. AORN Journal, 90(6), 926-929. doi:10.1016/j.aorn.2009.11.043

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What is the ANA’s Position on Current Legislature?

Posted by Laura on February 1, 2015

Current legislature in congress is posted at this site. The site shows how the ANA stands in each Bill. How do you stand? How does your congressman stand? What has happened to some of issues in Congress? Play around with the site and see what you can find.

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Words of Evaluation

Posted by Laura on January 29, 2015

 Who is making the evaluation?

A Licensure – done by a governmental authority, such as: for a practitioner or healthcare organization, so they may engage in their profession or occupation.

Example: Maria Gomez, RN

A Certification – done by a authorized body, such as: for evaluating and/or recognizing an individual or organization fulfills predetermined requirements.

Example: BLS

An Accreditation – done by a voluntary independent institution or organization, such as: a review to developed standards which can be measured.

Example: The Joint Commission

A Peer Review - doen by equal standing in same profession, such as: evaluation of professional performance.

Example: Research papers reviewed by qualified members in the same profession, or student to student review of care plans.

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My Reflective, Practice and Trends Course

Posted by Laura on January 27, 2015

In this class we looked at nursing theories, ethical sound behavior in nursing, technological advances in the health care field, economics, patient self-determination and ethics in research.

Sites mainly used were:

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Now, try another interactive reputable site!

Posted by Laura on January 27, 2015

The Henry J. Kaiser Family Foundation

This site has interactive facts and figures on maps and charts. You can compare various health conditions by state or by country. I selected State, then disease process. Selected to see the information in a Map – and did you know,

In regards to persons with a diagnosis of HIV infection, in the US

California had the most cases of 5,965

Florida next at 53,94

Texas at 5,044

New York at 4,944

Check out the Map!              Estimated Numbers of HIV Diagnoses Adults andAdolescents


The facts are pulled from the CDC – July 2013

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Information at your Finger Tips

Posted by Laura on January 25, 2015

I’m updating my website listings. There is so much information out there!

You will find my sites are mainly peer-reviewed sites – government agencies, reputable organizations. There are a few others which are not,  and they are listed under OTHER.

If you know a great nursing site you want to recommend – or a student in school doing a similar blog, send me your link and I’ll see about adding it.

here’s a fun one to try

                                               arrow                 World Life Expectancy

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. Is it Healthcare or Health Care? .

Posted by Laura on January 23, 2015

One of the words I try to keep straight on, especially with all the writing I do now, is health care.

When do you make it as one word, or two words, or do you hyphenate it as a catch all?

Healthcare has come into our language in different situations. Language changes all the time, especially when you start using words in a more relaxes atmosphere. Here is what I have come up with as a rule:

Healthcare - such as your healthcare professional (You:))  As a single word, is describes the noun. It is an adjective.


Health care - such as my health care is very important, is used as a noun.

From what I have read, healthcare, is more internationally used. Try to use the words broke up when doing papers in the US, unless it is a adjective – like the example above, or if it is stated as a proper name.

Eventually, like most things, time and cost will become factors and we will go to HC instead. Hope this helps!


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Posted by Laura on January 22, 2015

The SBAR provides safe communication when passing off information from caregiver to caregiver.





This is a modified example my instructor gave on the SBAR:

  • Dr. Pangelinan, this is Flora Cruz, RN, I am calling from Borja Hospital about your patient Rai Perez.

  • Here’s the situation: Mr. Perez is having increasing dyspnea and is complaining of chest pain.

  • The supporting background information is that he had a total knee replacement two days ago. About two hours ago he began complaining of chest pain. His pulse is 120 and her blood pressure is 126/55. He is restless and short of breath.

  • My assessment of the situation is that he may be having a cardiac event or a pulmonary embolism.

  • I recommend that you see him immediately and that we start him on O2 stat. Do you agree?

Read more here @ Home with The Joint Commission, or

Why is SBAR communication so critical?


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