You probably use email, Facebook and instant messenger to connect with friends and family. Have you considered those methods of communication for talking to your doctor? Recent studies suggest that patients are interested in new ways of communicating with their healthcare providers. A Manhattan Research study showed that 5 percent of respondents had sent or received an email from a healthcare provider and 49 percent were interested in email as a form of patient-doctor communication in the future. Another survey by Deloitte Center for Health Solutions found that 55 percent of consumers want to be able to communicate with their healthcare providers via email.
Continue reading to learn how a former NBA player communicates electronically with his doctor and the pros and cons of friending your doctor.
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IV insertion is often required for administering chemotherapy, antibiotics, blood products, fluids or other medical therapies. In patients with cancer, particularly people receiving repeated courses of chemotherapy, IV insertion may be difficult to achieve. There are various techniques nurses can use to improve IV insertion but few are evidence based.
A study published in the September 2009 issue of Oncology Nursing Forum studied whether dry or moist heat application to the upper extremity improves IV insertion rates. To read the full study, click here. (free registration required)
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Looking to save time or cut costs in the Cath Lab? New technology might be the answer. Five ideas to consider are: automated reporting software, use of radial access, access closure devices, automating inventory control systems and better staff responses.
Automated reporting software
Structured, automated reports can save time by eliminating dictation and transcription. In addition, with a structured reporting system doctors are required to use the same terms and descriptions, allowing for better data sorting and analysis.
Radial access
Jon Kao, M.D., Interventional Cardiologist at the University of Illinois at Chicago Medical Center (UIC) and the Jessie Brown VA Hospital in Chicago believes radial access can help speed percutaneous coronary interventions once doctors are proficient and comfortable with the technique. "Patients can sit up and walk around after a procedure, things that you can't do with femoral access," Kao said.
Access closure devices
In Cath Labs utilizing femoral access as the primary technique, access closure devices can save valuable nursing time. Compression requires a patient to lie on their back four to six hours with a nurse providing compression for 30-40 minutes. "Access closure devices help increase throughput by getting patients out of the lab more quickly. The nice thing about a closure device is you can close the patient on the table, even when they are fully anticoagulated," Kao said.
Automating inventory control systems
The ability to automatically track inventory can save both time and money in the Cath Lab. Integrated systems utilizing bar-coding or passive radio-frequency identification (RFID) can allocate charges to patient bills and subtract items from inventory counts. The systems can also generate detailed clinical and cost reports that can help keep budgets on track.
Better support staff responses
Streamlining staff and patient flow is an important part of creating an efficient Cath Lab. "The problem I have seen that crushes efficiency here is that we are so dependent on other departments and services," Kao said. "If house cleaning hasn't cleaned the lab yet, I can't bring the next patient in... If a room is not ready, I have to have a nurse watch the patient and they can't be available for the Cath Lab." One way to track both patient and staff movement is by using a personal digital assistant (PDA) based system. Orders can be entered into the system and messages are sent to responsible support staff.
To learn more about how technology is streamlining the Cath Lab, continue here.
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With the current state of the economy, hospitals are looking for ways to save money while maintaining high standards of patient care. Hospitals are examining supply management, employee turnover and drug usage as well as getting employees involved in the analysis. "They are training staff to see where waste is and how to get rid of it," said Richard Gundling, Vice President of the Healthcare Financial Management Association.
Continue reading here to learn how some Kansas City hospitals are cutting costs.
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Although many infection headlines are related to hospitals, individual doctor's offices are facing similar challenges. Almost 30 cases of hepatitis B were recently tied to one doctor's office in New Jersey. When health inspectors visited the office they found blood on the floor of a room where chemotherapy was administered, blood in a bin where blood vials were stored, unsterile saline and gauze as well as open medication vials. Inspectors also noticed cross-contamination of pens, refrigerators and countertops, use of contaminated gloves and misuse of antiseptics.
Patients were sent a letter from state epidemiologist Dr. Christina Chan urging testing for hepatitis B. "Evidence gathered at this time suggests that since 2002, some clinic staff provided care in a manner that puts patients at risk for infection caused by bloodborne viruses, including hepatitis B," the letter told patients. "The investigation to date suggests that hepatitis B infections identified may be associated with the method by which medications were administered and procedures performed at the practice."
Numerous checklists and recommendations have been published around infection control. The American Academy of Pediatrics Committee on Infectious Diseases and Committee on Practice and Ambulatory Medicine offers these infection control musts:
- Hand washing
- Barrier precautions to prevent skin and mucous membrane exposure
- Proper handling of sharps and contaminated waste
- Appropriate cleaning and disinfecting of surfaces and equipment
- Aseptic technique for invasive procedures
For the full recommendation on infection control in physician's offices, click here.
To read more about the hepatitis B outbreak in New Jersey, continue reading here.
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Many hospitals around the country are expanding their use of wireless technology. With the increase in technology, nurses are becoming more tech-savvy and leveraging new tools to improve patient care.
One medical center in Ohio is utilizing a hands-free communication system to enable clinicians to call for assistance or answer pages by utilizing voice recognition. This system helps nurses effectively manage multiple tasks while increasing inter-departmental communication.
Hospitals are also using new technologies to streamline process flow and improve patient safety. Children's Hospital Boston uses a patient flow platform that has helped eliminate many manual processes and keep patients moving. The hospital is also piloting bar-coding for medication administration in three of its units. The system can sound an alert if a medication is about to be given inappropriately. This alert can allow for intervention before a medication error occurs.
One key to successfully implementing new technology in a hospital is including clinical stakeholders in the planning phases. "Nursing is at the table. They are the drivers. We've been very successful, largely because I think we're a very listening organization. We pay close attention to what is needed, rather than the next bells and whistles that technology can deliver," said Mary Alice Annecharico, M.S., CIO of University Hospitals of Cleveland.
To read more about new hospital technology and how nurses are at the forefront, click here.
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The Joint Commission Center for Transforming Healthcare is working on its first improvement venture: The Hand Hygiene Project. According to the Centers for Disease Control and Prevention, an estimated 2 million patients get a hospital-related infection every year and 90,000 die from their infection.
Causes of Failure to Clean Hands
- Ineffective placement of dispensers or sinks
- Hand hygiene compliance data are not collected or reported accurately or frequently
- Lack of accountability and just-in-time coaching
- Safety culture does not stress hand hygiene at all levels
- Ineffective or insufficient education
- Hands full
- Wearing gloves interferes with process
- Perception that hand hygiene is not needed if wearing gloves
- Healthcare workers forget
- Distractions
Early results of the program found on average that caregivers washed their hands less than 50 percent of the time. "Demanding that healthcare workers try harder is not the answer. These healthcare organizations have the courage to step forward to tackle the problem of hand washing by digging deep to find out where the breakdowns take place so we can create targeted solutions that will work now and keep working in the future," said Mark R. Chassin, M.D., M.P.P, M.P.H., president, The Joint Commission.
By January, 2010, the Joint Commission Center for Transforming Healthcare plans to have data to demonstrate whether the proposed hand hygiene solutions can be sustained to achieve a 90+ percent compliance rate.
Eight hospitals are participating in this project:
- Cedars-Sinai Health System, Los Angeles, California
- Exempla Lutheran Medical Center, Wheat Ridge, Colorado
- Froedtert Hospital, Milwaukee, Wisconsin
- The Johns Hopkins Hospital and Health System, Baltimore, Maryland
- Memorial Hermann Health Care System, Houston, Texas
- Trinity Health, Novi, Michigan
- Virtua, Marlton, New Jersey
- Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina
To read the full release from the Joint Commission for Transforming Healthcare, click here.
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Healthcare providers are on alert due to an increase in a new strain of hospital-acquired infections. A recent study released by Arlington Medical Resources (AMR) and Decision Resources, found that recurrent
Clostridium difficile is difficult to treat in a hospital setting.
Clostridium difficile is a bacterium that can cause symptoms as minor as diarrhea and as life threatening as severe inflammation of the colon. The elderly are most at risk and the Centers for Medicare and Medicaid services is considering adding Clostridium difficile to its list of "never events" or preventable hospital-acquired infections. Hospitals will receive reduced or no Medicare payments for infections on the "never events" list.
Read more about how the study was conducted as well as more information on Clostridium difficile here.
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Jeanne Hahne was working as a nurse in a burn ward when inspiration struck. Because the patients were so vulnerable to infection, Hahne and other healthcare providers had to wear full protective gear including a cap to cover her hair and a mask that covered the majority of her face. Even though she worked with many of the burn patients every day, most couldn't recognize her.
Flash forward almost 30 years and Hahne has designed a face mask made of clear plastic so patients can see her smile. Hahne believes she can reassure patients with a smile and help decrease their anxiety. The masks also have utility for patients and healthcare providers with hearing loss since they allow for lip reading. In addition, the masks have helped improve communication between healthcare workers which can help decrease the chance for mistakes or misunderstanding. To read more and see pictures of the face mask, click here.
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