Emily Todd – Independent Project

Emily Todd – Independent Project

Class of 2017

Introduction to Topic

With having strong medical ties in my family, I have seen and heard a lot of issues over the years and a lot of different viewpoints on each issue. Much of issues that I would over hear were more procedural or hospital regulation issues than any other. At first, I didn’t see the big deal or fully understand why these issues were such a big deal. Now, after seeing firsthand where these issues begin and their overwhelming frequency, it’s not a surprise that now things make a lot more sense. For my project, I wanted to connect with the career path I want to pursue-nursing- and try to find solutions to problems that I would have to face in the not-so-far off future.

Project Description

For my independent project, I looked at some of the common issues that (mainly) nurses and other medical staff face on a daily basis. For my experience, I shadowed nurses on the Telemetry Unit at Upper Chesapeake Medical Center, which was one of the best opportunities I could have been given as I pursue a career in nursing. For my innovations, I created new protocols that would give hospitals some individual power over the rules of the Medicare system and help increase hospital efficiency. I also decided to create a Discharge Unit using Sketch up that would help free up beds for new patients being admitted to the hospital while also giving patients who are ready for discharge, but are waiting for family or transport to another health care facility. My main goal for both of my innovations is to help hospitals save money and earn more funding from the federal government and their states government, while also increasing the efficiency in patient flow.

Experience Description

My shadowing experience was all over the place with figuring out what to do and where to go and eventually relating it back to a topic. After finally recovering from my hand injury, I decided on shadowing on my mother unit at Upper Chesapeake Medical Center. Although I had never meet any of the day shift nurses prior to my shadowing, I already knew a lot about some of the nurses with the help of my mom. They all have heard my mom talk about my family and I, which actually ended up helping me connect with all the different nurses I had the opportunity to shadow with. At first, it was a little difficult and boring because there had been some miscommunication about what and why I was shadowing nurses, but by my third week into shadowing just about everyone had a much better understanding of what was going on. It was very frustrating at times that I technically was not allowed to do much other than just stand around watching the nurses, especially since I am the type of person that cannot stand still watching someone who could use an extra hand and not be able to help. I did however get to help with the little things, such as filling up patient’s water cups when they had to take their medications or running to the supplies closet to grab lotion or something. One day I actually got to help out by labelling patient documents with their respective sticker labels. This day, the hospitals electronic computer system was down and nurse were running out of labels. They could not print off more labels until the system came back online so they scanned the labels that were left, made copies, and then taping those paper labels to the necessary papers. That was definitely one of the craziest days over the course of my shadowing. On this unit, there seemed to be a lot of older or elderly people with chronic illnesses such as Parkinson’s or Congestive Heart Failure (CHF). There were not typically a lot of younger people most days. On several of the days I shadowed, I talked to them about Medicare and how it all works. Learning about the three-day admission stay was weird because I did not know insurance companies could make you stay in the hospital, longer than you need to, just so you can get the insurance company to cover the costs of ones stay. When the nurses and I would discuss the patient satisfactory surveys, the conversation tend to circle around patients abusing the system to get to stay in the hospital longer, similar to them staying in a hotel, and how this affects the hospitals scores. There were also plenty of days where the nurse and I would be just waiting around for a patient to leave, but their rides were not there yet. This was commonly frustrating, especially with the dementia and Alzheimer’s patients that like to wander around the unit, when they are not supposed to be. There were several times the nurse had to wheel out a patients chair into the nurse’s station so everyone could keep an eye out for them and make sure they did not go anywhere.

Innovation Description

These common problems gave me the idea to make new protocols and the discharge unit. The protocols include changing the 30-day readmission criteria, evaluating extended stay patients, and using special circumstances to bypass the three-day admission for Medicare coverage. The readmission protocol looks at why patients are being admitted, what happened when they were being discharged, why were they here for their previous admission, and assess how the penalties should be laid out. For patients with chronic illnesses especially, this protocol would see if the patient is being compliant with them at home medications and of they followed the instructions from the discharge papers. When patients are non-compliant, the hospital is not penalized for the readmission, unless there is something wrong with the prescribed prescription. The protocol for patients who have been admitted for over seven days is meant to increase the patient flow. This protocol makes the patients care team- physician, case worker, nurse, charge nurse, and patient car technician, as well as a nurse practioner and a scribe- to look over the patient’s current plan of care and look at if anything needs to be changed. This will also give the staff more say in the matter of patients that like to think a hospital is a hotel. When patients are admitted for extended periods of time for non-medical reasons, staff tend to grow distant from the patient and lose that connection with them. This is especially true for patients that sit in their bed all day, do not make any attempt to get out and do anything, refuse medications as well as consults. The special circumstances for bypassing the Medicare minimum of three-day admission stay includes instance such as a Code Red, where the hospital has no free beds and cannot accept any new patients. This protocol will also give the patient the opportunity to be discharged when they are no longer in need of hospital amenities and are in optimum condition that they can go home or be transferred to a long-term healthcare facility.

The Discharge Unit is similar to a waiting room, but with a few extra features. The purpose of this discharge unit is to help aid in the flow of patients out of the hospital. For patients that are stable for transport and/or waiting for family to come pick them up from the hospital, they would come to sit down in this discharge unit. For patients that want privacy or have a condition that prevents them from being able to sit in a chair and need to stay in a bed, there are private rooms available. The rest of the patients sit, talk, read, or watch TV until their respective ride arrives. There is an access hallway that connects specifically to the emergency department of the hospital in the case of emergencies. There are two sliding glass doors with the nurse’s station in-between them: one is for transporters to check in and collect the patients discharge papers and the other door is for patient family members picking up the patient. All the patient’s paperwork is held at the nurse’s station (unless the patient asks otherwise) until the patient is ready to leave so nothing is lost or left behind, or at least the chances of such are reduced. There is a crash cart behind the nurse station in the case of an emergency. There is a vending machine with food and one with drinks if patients are hungry and do not want to walk to the cafeteria.

Project Topic

Introduction to Topic

With having strong medical ties in my family, I have seen and heard a lot of issues over the years and a lot of different viewpoints on each issue. Much of issues that I would over hear were more procedural or hospital regulation issues than any other. At first, I didn’t see the big deal or fully understand why these issues were such a big deal. Now, after seeing firsthand where these issues begin and their overwhelming frequency, it’s not a surprise that now things make a lot more sense. For my project, I wanted to connect with the career path I want to pursue-nursing- and try to find solutions to problems that I would have to face in the not-so-far off future.

Project Overview

Project Description

For my independent project, I looked at some of the common issues that (mainly) nurses and other medical staff face on a daily basis. For my experience, I shadowed nurses on the Telemetry Unit at Upper Chesapeake Medical Center, which was one of the best opportunities I could have been given as I pursue a career in nursing. For my innovations, I created new protocols that would give hospitals some individual power over the rules of the Medicare system and help increase hospital efficiency. I also decided to create a Discharge Unit using Sketch up that would help free up beds for new patients being admitted to the hospital while also giving patients who are ready for discharge, but are waiting for family or transport to another health care facility. My main goal for both of my innovations is to help hospitals save money and earn more funding from the federal government and their states government, while also increasing the efficiency in patient flow.

Experience

Experience Description

My shadowing experience was all over the place with figuring out what to do and where to go and eventually relating it back to a topic. After finally recovering from my hand injury, I decided on shadowing on my mother unit at Upper Chesapeake Medical Center. Although I had never meet any of the day shift nurses prior to my shadowing, I already knew a lot about some of the nurses with the help of my mom. They all have heard my mom talk about my family and I, which actually ended up helping me connect with all the different nurses I had the opportunity to shadow with. At first, it was a little difficult and boring because there had been some miscommunication about what and why I was shadowing nurses, but by my third week into shadowing just about everyone had a much better understanding of what was going on. It was very frustrating at times that I technically was not allowed to do much other than just stand around watching the nurses, especially since I am the type of person that cannot stand still watching someone who could use an extra hand and not be able to help. I did however get to help with the little things, such as filling up patient’s water cups when they had to take their medications or running to the supplies closet to grab lotion or something. One day I actually got to help out by labelling patient documents with their respective sticker labels. This day, the hospitals electronic computer system was down and nurse were running out of labels. They could not print off more labels until the system came back online so they scanned the labels that were left, made copies, and then taping those paper labels to the necessary papers. That was definitely one of the craziest days over the course of my shadowing. On this unit, there seemed to be a lot of older or elderly people with chronic illnesses such as Parkinson’s or Congestive Heart Failure (CHF). There were not typically a lot of younger people most days. On several of the days I shadowed, I talked to them about Medicare and how it all works. Learning about the three-day admission stay was weird because I did not know insurance companies could make you stay in the hospital, longer than you need to, just so you can get the insurance company to cover the costs of ones stay. When the nurses and I would discuss the patient satisfactory surveys, the conversation tend to circle around patients abusing the system to get to stay in the hospital longer, similar to them staying in a hotel, and how this affects the hospitals scores. There were also plenty of days where the nurse and I would be just waiting around for a patient to leave, but their rides were not there yet. This was commonly frustrating, especially with the dementia and Alzheimer’s patients that like to wander around the unit, when they are not supposed to be. There were several times the nurse had to wheel out a patients chair into the nurse’s station so everyone could keep an eye out for them and make sure they did not go anywhere.

Innovation

Innovation Description

These common problems gave me the idea to make new protocols and the discharge unit. The protocols include changing the 30-day readmission criteria, evaluating extended stay patients, and using special circumstances to bypass the three-day admission for Medicare coverage. The readmission protocol looks at why patients are being admitted, what happened when they were being discharged, why were they here for their previous admission, and assess how the penalties should be laid out. For patients with chronic illnesses especially, this protocol would see if the patient is being compliant with them at home medications and of they followed the instructions from the discharge papers. When patients are non-compliant, the hospital is not penalized for the readmission, unless there is something wrong with the prescribed prescription. The protocol for patients who have been admitted for over seven days is meant to increase the patient flow. This protocol makes the patients care team- physician, case worker, nurse, charge nurse, and patient car technician, as well as a nurse practioner and a scribe- to look over the patient’s current plan of care and look at if anything needs to be changed. This will also give the staff more say in the matter of patients that like to think a hospital is a hotel. When patients are admitted for extended periods of time for non-medical reasons, staff tend to grow distant from the patient and lose that connection with them. This is especially true for patients that sit in their bed all day, do not make any attempt to get out and do anything, refuse medications as well as consults. The special circumstances for bypassing the Medicare minimum of three-day admission stay includes instance such as a Code Red, where the hospital has no free beds and cannot accept any new patients. This protocol will also give the patient the opportunity to be discharged when they are no longer in need of hospital amenities and are in optimum condition that they can go home or be transferred to a long-term healthcare facility.

The Discharge Unit is similar to a waiting room, but with a few extra features. The purpose of this discharge unit is to help aid in the flow of patients out of the hospital. For patients that are stable for transport and/or waiting for family to come pick them up from the hospital, they would come to sit down in this discharge unit. For patients that want privacy or have a condition that prevents them from being able to sit in a chair and need to stay in a bed, there are private rooms available. The rest of the patients sit, talk, read, or watch TV until their respective ride arrives. There is an access hallway that connects specifically to the emergency department of the hospital in the case of emergencies. There are two sliding glass doors with the nurse’s station in-between them: one is for transporters to check in and collect the patients discharge papers and the other door is for patient family members picking up the patient. All the patient’s paperwork is held at the nurse’s station (unless the patient asks otherwise) until the patient is ready to leave so nothing is lost or left behind, or at least the chances of such are reduced. There is a crash cart behind the nurse station in the case of an emergency. There is a vending machine with food and one with drinks if patients are hungry and do not want to walk to the cafeteria.

By | 2017-05-24T20:06:09+00:00 May 24th, 2017|Biomed Capstone Project 2017|0 Comments

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