Health Care POV

The Summer Begins

Devon Alley — Sat, 25 May 2013 12:00:00 GMT

A.'s last day of school was this past week, and we've been able to watch her transition into summer life. It's always interesting, because, as much as A. complains about going to school, in the summer she always complains about being bored. Summer is also the time that A. begins to get interested in being extremely interactive with Thomas and I -- she wants to show us things, wants to talk to us about things, and will spend a lot more time in the common rooms of the house, just so she can be near...(read more)

To document or not to document? That is the question.

Lorenzo Ortega — Sat, 25 May 2013 04:04:00 GMT

A little over two months have passed in my time as an employed registered nurse. My comfort level continues to increase step by step and my new graduate residency program has pushed on past the halfway point of the 18-week program. Up until this point I was having two 6-hour class sessions a week. Soon those two 6-hour sessions will be replaced by one 12-hour shift and my schedule will begin to look more like the real deal RN schedule. However, a significant obstacle remains this final week of classes before our group moves forward. Marking the conclusion of our classes, we will have a testing process called “oral boards”. In a most nerve-wracking set-up, we will each be presented case study scenarios in front of various unit managers and expected to answer an array of questions. Like the NCLEX and a job interview rolled into one, not many of my colleagues have been thrilled about this upcoming test. However, I can honestly say that I feel as though all of my fellow residents (7 to be exact) are more than capable of doing a phenomenal job during these oral boards. During the 12 weeks we have been together I have been continually impressed with the critical thinking capabilities of my colleagues and have no doubt we will all excel during our testing.

With regards to my clinical practice, I feel as though I have growing by leaps and bounds since I started. In nursing school you worry a lot about tasks. Now that I have the RN behind my name I find myself more worried about other things, one being my documentation. Time and time again we have had nurses come speak to our group about personal stories in which documentation saved their licenses. It makes me unease to think that any day in the future I could be put under the microscope and scrutinized, but this is what I signed up for. Now my mind is set on not only becoming a great nurse, but being extremely diligent in my written work. In nursing school, so many things were stressed‒ safety, patient advocacy, assessing and thinking ahead, leadership, among many others, but I feel as though documentation was not stressed as much as it should have been. I almost wish that we would have had specific classes in documentation, something I know I would find useful at the present moment.

School thoughts aside, I am enjoying having much more time to enjoy my life again. I really am excited to start some new hobbies now that summer is on the verge. My girlfriend just moved down to Pismo Beach, CA for an RN job, so who knows, maybe I’ll pick up surfing this summer. I have a backpacking trip planned for next week in Sequoia National Park and I can’t wait to keep it going with something adventurous each week. I’ll be sure to keep checking in!

DSM-5 Has Arrived

Jill Glomstad — Fri, 24 May 2013 21:09:00 GMT

[Guest blogger Stacey Miller is editor of our sister publication, ADVANCE for Speech-Language Pathologists & Audiologists .] The Fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released May 18 during the APA's annual meeting in San Francisco. In the days leading up to the official announcement of the changes, controversy began brewing. ADVANCE has reported on the changes coming to autism diagnoses, most notably the elimination...(read more)

ICD-10: An Important and Positive Change

HealthStream ® — Fri, 24 May 2013 18:36:00 GMT

(This sponsored blog was written by Lee Ann Bryant, associate product manager, HealthStream.) If you work in any healthcare environment, you know how inundated we have become with information around ICD-10 - most of it leaning toward the negative end of the spectrum. Yes, there is a lot to learn. Yes, there are time and financial burdens involved. Yes, it is one of the most significant changes ever for the healthcare industry. And Robert Tagalicod, director, Office of E-Health Standards and Services,...(read more)

MTs Ride the Waves of Change

Sharlene George — Fri, 24 May 2013 17:48:00 GMT

(Editor's Note: This guest blog was written by Vicki J. Brown, director of HIM Solutions Marketing, Nuance Communications.) As we reflect on National Medical Transcription Week, May 19-25, 2013, I can't help but think about the waves of transition this industry has experienced in the past decade and lessons learned from our customers. I also ponder the perfect storm facing the MT world today and what lies ahead. Typing Wave Ten years ago, most healthcare organizations created and managed clinical...(read more)

The TERT Gene

Michael Jones — Fri, 24 May 2013 17:02:00 GMT

We’ve discussed dark matter before . Understanding the unobserved and unknown areas of the human genome could ultimately lead to a better understanding of cancer and, subsequently, better treatment options. A Dark Daily news briefing reported recent studies in dark matter, which cited the telomerase reverse transcriptase (TERT) gene as being linked to melanoma. Separate research projects in Germany and at Harvard Medical School noted the role of an overactive TERT gene in cancerous cells. According...(read more)

The TERT Gene

Michael Jones — Fri, 24 May 2013 16:59:00 GMT

If You’re Not Patient-Centered, Walmart Will Be

Adrianne OBrien — Fri, 24 May 2013 15:14:00 GMT

Editor’s note: This blog was written by Anthony Cirillo, FACHE, a healthcare consultant and aging expert who helps CEOs connect the dots that start healthcare movements. Contact him at cirillo@4wardfast.com and learn more at www.4wardfast.com . Two JAMA articles last month caused me to pause. In the first, published online by JAMA Internal Medicine , a survey of almost 22,000 admitted patients at the University of Chicago Medical Center found patient preference to participate in decision making concerning...(read more)

Social Security

Tim Banish — Fri, 24 May 2013 13:53:00 GMT

Were you aware that there are 54.8 million people in the U.S. receiving Social Security benefits? That is 17.6% of our population. With the baby boomer generation adding to those numbers daily, the fund could be depleted by 2033. Began in 1935 by Congress to provide "old age benefits" for families, workers and employers combined paid 2% of their annual salary. Today that figure is 12.4%, with the employee and employer each paying 6.2%. In 1956 the law was amended to allow disability benefits for...(read more)

Seeking Help on Asthma Care

Kevin Johnson — Fri, 24 May 2013 12:50:00 GMT

As I mentioned a few blogs ago, I am currently taking a prep course with the goal of obtaining my Asthma Educator credential. I am very excited and thankful for the opportunity to do this, as the hospital I work for is footing the bill, and have no doubts that having my AE-C will be a good thing for me as a Respiratory Therapist and for my patients. But I am a little in the dark about how I can use this credential to the greatest benefit for myself and my patients. I have already talked with my hospital's...(read more)

Trialing AAC with PECS Users

Valerie Lill — Fri, 24 May 2013 12:25:00 GMT

Last month I did a survey asking for two topics from my state's annual convention you'd like to hear about. One of them was "Strategies for Transitioning from PECs to SGD." I had the privilege of hearing Lori Frost, the co-author of the PECs training manual, speak on this topic. I learned so many things that I am just going to go over a few highlights and things to consider when considering trialing AAC devices and apps with PECS users. Core Vocabulary - I really am a big supporter of using core...(read more)

Recipe: Broiled Lemon-Parmesan Tilapia

Stephanie Bruno-Dowling — Fri, 24 May 2013 12:13:00 GMT

Even though the calendar is still reading SPRING, it certainly feels like summer outside! The hot weather has arrived! This time of year always inspires me to eat light and healthy. I add more fresh fruits and vegetables to our family diet, as well as various types of seafood. Today I'd like to share a family favorite that highlights tilapia as the main ingredient! Tilapia has very mild flavor and is a soft white fish that breaks apart easily when cooked. If your child is old enough and able to eat...(read more)

Use the Gram Stain

Scott Warner — Fri, 24 May 2013 10:18:00 GMT

In microbiology we learn to use the Gram stain results of a direct smear to check specimen quality (usually by a count of squamous epithelial cells) and any predominating organisms (e.g. lancet shaped Gram positive cocci on a sputum) that suggest what to work up. All good micro techs use the Gram stain. Intracellular organisms are an immediate clue of what’s causing an infection. If an organism is seen on the Gram stain and not seen on the plates, it could indicate that the patient is being treated,...(read more)

Are We Affordable and Accessible?

Lisa Mueller — Thu, 23 May 2013 22:16:00 GMT

Those are two powerful words in healthcare today -- "accessible" and "affordable." We (healthcare providers) need to be accessible and affordable to patients in order to provide care, period. Those two words don't even begin to address quality or evidence-based care, but simply allow patients the opportunity to receive care. This concept is more global than just a physical therapy clinic and is probably more of a public service barrier to care, but the idea intrigues me. The biggest question I have...(read more)

Not on My Watch

Guest Blogger — Thu, 23 May 2013 22:02:00 GMT

By Diane M. Goodman, APRN, BC, MSN-C, CCRN, CNRN A group of nurses had gathered to inhale a quick lunch. The topic for the day was medication safety. We reviewed a recent article (posted online) that discussed the importance of minimizing interruptions to nursing workflow, particularly during medication administration. In the posted scenario, a nurse had prepared chloral hydrate as a pre-medication, and had the medication ready to dispense on her mobile cart. While engaging in a brief social conversation,...(read more)

Let the Fun Begin!

Karen Schiff — Thu, 23 May 2013 21:34:00 GMT

The dining room table no longer is clear. It's covered with journal articles, the Guide to PT Practice , and numerous notes from all of the classes I've completed so far. With the final two classes upon me, I'm feeling quite a bit overwhelmed and I'm not sure why. Previous classes have been quite challenging, and now that I have to incorporate all that I've learned with what I know, and apply it to my patient case report, I'm not sure how to put it all together in one document. Thankfully, I'll have...(read more)

Rain Makers

Jason Marketti — Thu, 23 May 2013 20:09:00 GMT

From the moment we set foot in a facility, we're on the move. We're expected to be productive throughout our day by billing patients for our services. We make it rain for the facility but aren't always recognized for it. When I see every other department in a healthcare setting, they usually take up space and use resources that cost the facility money. Housekeepers use chemicals to clean a facility, nurses use syringes and bandages, the kitchen staff uses up food products. They don't directly contribute...(read more)

NADNP 2nd Annual Conference

Raymond Shulstad — Thu, 23 May 2013 19:40:00 GMT

I have been fortunate enough to have spent the last week at the 2 nd annual National Association of Dermatology Nurse Practitioners (NADNP) conference in Clearwater Beach, Fla. It has been personally rewarding to see all the hard work over the last year pay off as the conference has been a huge success. Professionally, it has been wonderful to see the mixture of dermatology specialists and primary care providers who have come to expand on their current knowledge base or begin to explore the specialty...(read more)

Myocardial Infarction Protocol

David Plaut — Thu, 23 May 2013 15:33:00 GMT

One of my pet concerns is the best rule out myocardial infarction protocol. Best includes rapid, high sensitive and high specificity tests with as few markers as possible. Recently, two articles from Australia and New Zealand added significant data to the issue. From Australia was an article comparing cardiac risk stratification using a 0 and 2 h POC cTn, 0 and 2 h POC multi-biomarkers against the 0 and 6 h laboratory cTn reference standard. Using the data from over 700 patients, the authors concluded...(read more)

Tweets of the Week (5.23.13)

Adrianne OBrien — Thu, 23 May 2013 14:16:00 GMT

New tweet list! Interoperability breakthrough near, treating Oklahoma victims, patient-centered medical homes and the Triple Aim, and graduation advice you wish you'd been given. Get daily tweets by following us @ExecInsight . FierceHealthIT CCHIT: Interoperability breakthrough near http://t.co/TemVnX9IPm Gunter F. Wessels SM Hospitals scramble to treat tornado victims - Treating injuries from tornadoes is a well-established job in Oklahoma. http://t.co/M24TGKct4L Billian's HealthData Hospital Pricing...(read more)

New Equipment Brings New Anxiety

Penny Mehaffey — Thu, 23 May 2013 14:09:00 GMT

Finally we were able to purchase new equipment for the lab that I have been dreaming about! I am expecting installation to begin next week and training the week after.

The prep work on our end -- checking the existing cabling and wiring connections for compatibility with the new system -- has been going on for a couple of weeks now. And about half of it will need to be replaced since our current system is, don't tell anybody, fairly old.

I have butterflies of anticipation. I am excited to have all new equipment ... and I am terrified to have all new equipment. Gone is the thrill of the hunt and purchase and it's been replaced with te occassional buyer's remorse and, "Oh no, what have I done?"

What if we hate the new stuff and what if it's not as user-friendly as I thought, and nobody can work it? That's the stuff nightmares are made of. I have been going to bed with visions of cable clutter in my head, and counting all the "what if's" that could go wrong. You'd think I would know better than that, and I do, but I just can't help myself. Try as I might, I can't summon those lovely little friends of mine that usually help me fall asleep. I look for sheep and get cable snakes instead.

On a happier, more personal note, my son is coming home on leave from the Air Force this week. He will be home today and here for about 30 days. Yay! I had scheduled vacation for the first week of June, but the delays associated with the new equipment have intruded. Originally the plans were for the installation to take place mid-May, so I have given up the first half of the week to the install, and will take the remainder in another week or so after installation is completed.

So, to answer the million dollar question as to whether things are settling down, nope! And probably not anytime soon. Maybe by the Fourth of July...

I miss my sheep.

A Team Approach

Jennifer Kay-Williams — Thu, 23 May 2013 12:22:00 GMT

To be honest, I find that collaborate more naturally with Occupational Therapists than Physical Therapists. This is not because I prefer or value one discipline over another in any way, but because OT goals seem to overlap more with ST goals than PT goals overlap. Still, I do find myself consulting and working with our PT team daily in order to help patients reach their goals. The PT department will often refer patients to me when they cannot recall directions and safety strategies across sessions....(read more)

Internal War Zone

Michael Jones — Wed, 22 May 2013 19:59:00 GMT

The more we learn about our own bodies, the more it seems like there’s just an endless war going on in there. Scientists have long since known about helpful bacteria inside of our bodies that help prevent infections, but an article from Medical News Today cited a US study from researchers at San Diego State University that noted viruses within the human body that also perform defensive tasks. Post-Doctoral Fellow, James Barr, and his research team dubbed the protective viruses “bacteriophages.” “Taking...(read more)

Internal War Zone

Michael Jones — Wed, 22 May 2013 19:59:00 GMT

It's All About the Money

Toni Patt — Wed, 22 May 2013 19:56:00 GMT

If I had any doubt that patient-focused healthcare was a thing of the past, I don't anymore. Last weekend, a situation arose that showed me charging for services was more important than patient care. I work full-time at one facility and help out at another. The second facility is an hour drive away by highway. It fell to me because I'm the only one willing to go there. I burn a tank of gas if I make two round trips. My company pays me drive time to the facility as an enticement to go there. Sometimes...(read more)