Student Nurse Laura

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

Archive for the ‘Day-to-Day’ Category

Study, Study, Work, Work

Posted by Laura on September 9, 2015

So much activity away from the .com site.

Will hopefully reconnect in a few months : )))

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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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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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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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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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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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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

DDS3

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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.

 

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Basic Concepts in Healthcare Information Management

Posted by Laura on February 7, 2015

SPC

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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

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

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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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