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This is the first of a two-part series on psychiatric patients in the ED. This month, we cover ways to improve care, ensure safety, and maintain throughput. Next month, we give strategies for reducing risks of chemical and physical restraints.
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In light of increasing numbers of psychiatric patients at St. Rose Dominican Hospital in Henderson, NV, the following steps were taken to ensure safety of ED patients and staff.
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A nurse pulls out a 10,000 units per cc concentration of heparin for a cardiac patient double the correct dosage. Did this patient get twice the dose of heparin, resulting in bleeding complications? No, because the dosage was double-checked by a second ED nurse, so the error never occurred, reports Sharon A. Graunke, RN, MS, CEN, TNS, ED clinical nurse specialist at Elmhurst (IL) Memorial Hospital.
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Are potential violations of the Emergency Medical Treatment and Labor Act high on your worry list? Heres another high-risk area that you should add to your list: Occupational Safety & Health Administration (OSHA) citations for violations of the Bloodborne Pathogens Standard (BPS). This standard requires you to take steps to protect health care workers from needle stick injuries.
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When health care costs for its employees soared by 60% and out-of-network claims increased by 20% in just a few years, Davis Memorial Hospital in Elkins, WV, took action. The 90-bed community hospital called on the expertise of Tod Thorpe, RN, CPC-H, its former case management director, to manage the health care of its 650 full-time equivalent employees.
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The Breakthrough Series Collaborative model effectively employed by the Institute for Healthcare Improvement (IHI) on a national level has been translated successfully to the regional level in the state of Washington, achieving significant improvement in the self-care efforts of diabetes patients and clinical improvements in areas such as blood sugar and cholesterol.
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Physicians aligned with Sutter Health in Sacramento, CA, are giving glowing reviews to a care coordination program they once failed to recognize, pleased that it is meeting myriad patients needs and saving office time in the bargain.
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After working 15 years as a discharge planner and earning masters degrees in nursing and clinical research, theres an incongruity that Diane Holland, RN, MS, MBS, who is now pursuing a PhD through the doctoral program at the University of Minnesota School of Nursing in Minneapolis, would like to resolve.
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Case managers often find themselves charged with the responsibility for solving problems without the accompanying authority needed to fix the problem. This can be very frustrating. You cant issue direct orders to solve the problem, so why should anyone listen to your suggestions?