Posted by Laura on February 21, 2015
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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?
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
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Posted by Laura on February 15, 2015
Patient Census are important for budgeting resources, but there is a difference in terms.
- 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
- 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.
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 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.
Posted by Laura on February 9, 2015
info retrieved from: Healthcare.gov
Posted by Laura on February 7, 2015
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:
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 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.
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.
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.
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:
Nurses’ Bill of Rights on the ANA website.
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Posted by Laura on January 27, 2015
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
The facts are pulled from the CDC – July 2013
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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
Posted in Day-to-Day | Comments Off on Information at your Finger Tips
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!
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
Posted by Laura on January 21, 2015
NANDA-Nursing Diagnoses, Definitions, and Classification
Nursing Interventions Classification System (NIC)
Clinical Care Classification System (CCC
Nursing Outcomes Classification (NOC)
Nursing Management Minimum Data Set (NMMDS)
Peri-Operative Nursing Data Set (PNDS)
Nursing Minimum Data Set (NMDS)
International Classification for Nursing Practice (ICNP®)
Logical Observation Identifiers Names and Codes (LOINC®)
Posted in Professional Practice | Comments Off on 12 Languages – How many do you know?
Posted by Laura on January 20, 2015
Standardized nursing language enables better communication among nurses and other health care providers. by increasing visibility of nursing interventions, standardized nursing language improves patient care and enhances data collection to evaluate nursing care outcomes.
You can read a nice article on standardized nursing language on the ANA site here: Standardized nursing language: What does it mean for nursing practice?
The ANA recognizes 12 languages. Two of them actually make up one of them. Where I work we use the Peri-Operative Nursing Data Set (PNDS). You can find the list here. This document has links to where you may find more information on each one.
Posted by Laura on January 18, 2015
Find This and more facts by The Joint Commission here
The Joint Commission “Do Not Use” List
|Official “Do Not Use” List||Potential Problem||Use Instead|
|U, u (unit)||Mistaken for “0” (zero), the number “4” (four) or “cc”||Write “unit”|
|IU (International Unit)||Mistaken for IV (intravenous) or the number 10 (ten)||Write “International Unit”|
|Q.D., QD, q.d., qd (daily)Q.O.D., QOD, q.o.d, qod(every other day)||Mistaken for each otherPeriod after the Q mistaken for “I” and the “O” mistaken for “I||Write “daily”Write “every other day”|
|Trailing zero (X.0 mg)*Lack of leading zero (.X mg)||Decimal point is missed||Write X mgWrite 0.X mg|
|MSMSO4 and MgSO4||Can mean morphine sulfate or magnesium sulfateConfused for one another||Write “morphine sulfate”
Write “magnesium sulfate”
Find This and more facts by The Joint Commission here
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Posted by Laura on January 17, 2015
One of my goals when I started the nursing field was to obtain my RHIT. I took one year of Health Informatics Technology, through a Health Workforce Training Program. This program is one of the ways the US government is trying to assist hospitals and physicians get trained individuals who understand the “meaningful use.” I learned a lot from this program, and am excited about the RHIT. I’ve already done some classes, some are excused because I am a nurse, and some are to come. So I will be putting a bunch of my school work on this site also. It helps me learn by regurgitating the information : ) Community colleges where given the short-term certificate programs for HIT workers I talked about. I was even part of grant, so I received my tuition back. Very nice. You can find more about it here. I’ll have upcoming links and categories under RHIT. For now, AHIMA or the American Health Information Management Association is the credentialing organization for “effective management of health data and medical records needed to deliver quality healthcare to the public.”
RN RHIT BSN RHIA MSN
NP (no problem)