Student Nurse Laura

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

Cancer Mortality Rates

Posted by Laura on March 31, 2015

Calculating Cancer Mortality Rates for a population is collected by the National Center of Health Statistics. They are classified by age, cancer site, race and sex.

Improvement of treatment for cancer can come from these rates. Hospital registries on cancer collect information about cancer patients. Specific diagnosis of cancer can further break down the statistics on cancer mortality rates.

ref: Horton, Loretta and Margaret Theodorakis. Calculating and Reporting Healthcare Statistics, Fourth Edition. AHIMA Press.

Posted in RHIT, Statistics | Tagged: , , , , | Comments Off

Anesthesia Death Rates

Posted by Laura on March 29, 2015

Anesthesia Death Rates are from the ratio of deaths in a specific period which were caused by anesthetic agents, and the number of anesthetics administered.

Various Types of Anesthesia

  1. General
  2. Moderate
  3. Sedative
  4. Regional
  5. Local

ref: Horton, Loretta and Margaret Theodorakis. Calculating and Reporting Healthcare Statistics, Fourth Edition. AHIMA Press.

Posted in Day-to-Day, RHIT, Statistics | Tagged: , , | Comments Off

Newborn Mortality Rates

Posted by Laura on March 27, 2015

Definitions for Newborn Deaths/Newborn Mortality Rates

Infant deaths – any time in the first year

Neonatal deaths – liveborn death within the neonatal period. 28 days

Newborn deaths – death of a hospital liveborn infant who dies during the same admission.

Perinatal deaths –  Stillborn and neonatal deaths.

Post-neonatal deaths – After the 28th day of life through the end of the first year.

Vital Statistics for Neonatal & Infant Mortality Rates

Birth certificates are used frequently for this data. The rate is times by 100,000 for use in vital statistics in the US.

ref: Horton, Loretta and Margaret Theodorakis. Calculating and Reporting Healthcare Statistics, Fourth Edition. AHIMA Press.

Posted in Day-to-Day, RHIT, Statistics | Tagged: , , , , | Comments Off

Fetal Death Rates

Posted by Laura on March 25, 2015

Fetal Death Rates are calculated separately and not considered patient deaths. There are three classifications of fetal deaths:

  1. Early (< 20wks of gestation  and wt 500 gm or less)
  2. Intermediate (20-28 wks of gestation wt of 501-1000 gm.)
  3. Late (28+ and wt of 1,001 gms or more)

 

Posted in RHIT, Statistics | Tagged: , , , , | Comments Off

Net Death Rate & Post-Op Death Rate

Posted by Laura on March 23, 2015

Accrediting agencies may request the Net Death Rate. This rate became important because providers had a concern on deaths less than 48 hours after admission  – they may or may not have death due to the hospitalization. Because of this, Net Death Rates excludes deaths under 48 hours.

 

Postoperative Death Rates and Surgical Death Rates refer to the same thing. It is the number of deaths occurring after an operation. In this rate, deaths 10 days after surgery are included.

Hospitals may evaluate the relationship of deaths in specific operations instead of using the postoperative death rate to evaluate the effectiveness of a hospital’s care.

ref: Horton, Loretta and Margaret Theodorakis. Calculating and Reporting Healthcare Statistics, Fourth Edition. AHIMA Press.

Posted in RHIT, Statistics | Tagged: , , , , | Comments Off

Mortality / Death Rates

Posted by Laura on March 21, 2015

Statistics on Death Rates is important to help public health agencies plan services where may be needed. One way this has been used is the call or need for new medical specialties. Have you heard of a doctor being a intensive care expert? The idea is intensivists can have a direct affect on death rates. There are many organizations who use this information befside hospitals and the CMS.

  • The Automobile Industry
  • Handgun Advocates
  • American Heart Association
  • American Cancer Association

To compute hospital death rates, formulas for calculating include the number of patient deaths divided by number of patient discharges (including deaths).

Note: DOA are not included, because they were not admitted to hospital.

Note: Fetal deaths,ER, and out-patients, are not included.

ref: Horton, Loretta and Margaret Theodorakis. Calculating and Reporting Healthcare Statistics, Fourth Edition. AHIMA Press.

Posted in RHIT, Statistics | Tagged: | Comments Off

Review for Exam

Posted by Laura on March 16, 2015

Some simple math calculations for review. Much like math for nursing, healthcare statistics has some basic concepts that progress in complexity. Knowing the exactly where the information is coming from, how to get the statistics, and what the results represent is the most important. But, for now, I’m just going to post some simple calculations and will comprise all in an excel document for future use.

Fraction to Percent – Fraction to Percent Calculator

Percent to Decimal – Percent to Decimal Calculator

How to get the Ratio – Ratio Calculator

Average (mean) – Average Calculator (Mean)

Sum of all values / Number of all the values involved

Census

Definitions

Census- calculate census, – Total number of patients treated during a 24 hour period.

Inpatient Service Days – Services received by one inpatient in 24 hour period.

Total Inpatient Service Days – Sum of all inpatient service days for each of the days in the period.

Purpose – planning, budgeting and staffing.

FORMULA – Average Daily Census:

Total inpatient service days (excluding newborns) / Total number of days in the period.

- for a Unit:

Total inpatient service days for the unit for the period / Total number of days in the period

 – for NB :

Total newborn inpatient service days for a period / Total number of days in the period

Occupancy

Definitions

Inpatient bed count – Number of available hospital beds, both occupied and vacant, on any given day.

Inpatient Bed count day – Counts the presence of one inpatient bed (occupied or vacant)that is set up and staffed for use in one 24 hour period.

Total inpatient bed count day – Sum of inpatient bed count days for each of the days in a period.

FORMULA – Percentage of occupancy – Total number of inpatient service days for a period (x 100) / total inpatient bed count days in the period (Bed count x Number of days in the period)

FORMULA – Percent of occupancy FOR Newborn Bassinet Occupancy Ration – Total newborn inpatient service days for a period x 100 / Total newborn bassinet count x Number of days in the period.

FORMULA – Bed Turnover Rate (direct)- total number of discharges for a period / average bed count for the same period.

FORMULA – Bed Turnover Rate (indirect)- Occupancy rate x Number of days in a period / average length of stay. Note: Used when the bed count changes during the period in question.

Length of Stay

Definitions

Length of Stay – Number of calendar days from admission to discharge.

Total length of stay – Sum of the days stay of any group of inpatients discharged during specific period of time.

Purpose – Utilization management to evaluate the facilities efficiency in provideing services cost-effectively, while evaluating level of care, example – Financial reporting

FORMULA – Length of Stay- calculate using discharge days (no Newborns) – Total length of stay of discharged patients for a given period / total number of discharges and deaths in the same period

Average Length of Stay  – Toatl length of stay (discharge days) / Total discharges (including deaths)

FORMULA – Average Newborn Length of Stay – Total newborn discharge days / total newborn discharges (including deaths)

Posted in Day-to-Day, RHIT, Statistics | Tagged: , | Comments Off

Body Mass Index

Posted by Laura on February 28, 2015

Body Mass Index

BMI

BMI2

 

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.

Posted in Day-to-Day | Tagged: , | Comments Off

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

Posted in Day-to-Day, RHIT | Comments Off

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

BED COMPLEMENT = BED COUNT = BED CAPACITY

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

Posted in RHIT | Comments Off

Another Name is…

Posted by Laura on February 22, 2015

Kassebaum-Kennedy Law

Public Law 104-191  1996

Posted in Day-to-Day | Comments Off

What is another name for

Posted by Laura on February 21, 2015

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

Posted in Day-to-Day | Leave a Comment »

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

      AHA!!   

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?

Posted in Professional Practice | Tagged: | Leave a Comment »

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: http://www.cdc.gov/healthyyouth/evaluation/pdf/SMARTcards.pdf

Posted in Professional Practice | Comments Off

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

 

Posted in Day-to-Day, RHIT | Comments Off

Evidence for Trail

Posted by Laura on February 13, 2015

DDS3

Posted in Day-to-Day | Comments Off

CONSENT AND AUTHORIZATION USED TO BE INTERCHANGEABLE

Posted by Laura on February 11, 2015

 

Current use under the AHIMA now states:

Consent is permission for treatment, payment, or healthcare operations

vs

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

Another,

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.

 

Posted in Day-to-Day, RHIT | Comments Off

Federally Funded CARE, Federally Funded AID

Posted by Laura on February 9, 2015

medicare medicaid

 

info retrieved from: Healthcare.gov

http://www.hhs.gov/answers/medicare-Medicaid/medicare-medicaid/difference-medicare-medicaid.html

Posted in Professional Practice, RHIT | Comments Off

Basic Concepts in Healthcare Information Management

Posted by Laura on February 7, 2015

SPC

Posted in Day-to-Day, RHIT | Comments Off

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

Cancer

Stroke

Lung Disease

Accidents

Alzheimer’s

Diabetes

Influenza-Pneumonia

Nephritis/Kidney

Blood Poisonings

Suicide

Liver Disease

Hypertension/Renal

Parkinson

Homicide

Data Retrieved from WHO, and

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

Posted in Day-to-Day | Tagged: , , | Comments Off