Student Nurse Laura

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

Games

Posted by Laura on April 27, 2015

How about playing a game?

Follow the link by selecting the image (from Microsoft clipart).

microsoft image

This game is brought to you by Health IT.gov.

“The security training module, which was developed with the assistance of the Regional Extension Center Program’s Privacy and Security Community of Practice, uses a game format that requires users to respond to privacy and security challenges often faced in a typical small medical practice.  Users choosing the right response earn points and see their virtual medical practices flourish.  But users making the wrong security decisions can hurt their virtual practices.  In this version, the wrong decisions lead to floods, server outages, fire damage and other poor outcomes related to a lack of contingency planning”.

 

 

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What is Justice?

Posted by Laura on April 17, 2015

“The challenge of applying the Belmont principle of justice is how to decide which criteria should be used to ensure that harms and benefits of research are equitably distributed to individuals and populations” (NIH Office of Extramural Research).

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What is Beneficence?

Posted by Laura on April 16, 2015

Ethics in securing well-being

Two general rules are articulated as expressions of beneficent actions:

  1. Do no harm
  2. Maximize possible benefits and minimize possible harms

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What is an Autonomous Person?

Posted by Laura on April 15, 2015

Autonomous Person

  • An autonomous person is able to consider the risks and benefits of a situation
  • An autonomous person and then analyze how they relate to their own personal goals and values
  • An autonomous person can then take action upon their analysis

The Informed consent will provide the information the require. If anyone has diminished autonomy, then additional protection should be given. Children, people with developmental disorders, dementia, or disabilities should be given the respect of providing protection.

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NIH Office of Extramural Research

Posted by Laura on April 14, 2015

Respect

Beneficence

Justice

The Belmont Report – Ethical Principles and Guidelines for the Protection of Human Subjects of Research by the National Commission drafted in 1979. These words are the foundation of the HHS (Health and Human Services) on human subjects in research.

find at:   http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html

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Autopsies

Posted by Laura on April 8, 2015

autopsies 001

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Formulas on Death Rates

Posted by Laura on April 6, 2015

Death Rates

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Maternal Death and VS on Maternal Death Rates

Posted by Laura on April 2, 2015

Incidental (suicide or homicide) or accidental (MVA or Fall) causes are not included in the Maternal Death RateIt is the death of a woman from causes related to pregnancy or its management of. Direct and indirect OB deaths can be specific also. Direct OB involves the pregnancy such as a hemorrhage due to a c-section. Indirect OB death may be from a co-morbidity such as Diabetes.

Note: do not include non-maternal deaths (accidental or incidental).

Vital Statistics on Maternal Mortality Rates are used in public policies and health studies. They are usually states per 100,000. The WHO has great information on Vital Statistics on death rates.  Visit http://www.who.int/topics/mortality/en/

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

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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.

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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.

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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.

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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)

 

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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.

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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.

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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)

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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.

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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

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

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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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