The document provides guidance on documentation expectations for activities of daily living (ADL) coded in nursing home resident assessments. It clarifies that facilities can determine which staff complete ADL documentation and the format used, as long as it is consistent with good clinical practice standards. An example is provided to illustrate how ADL documentation should accurately reflect and support changes in a resident's condition and functional status over time. Contact information is given for questions about relevant rules and assessments.
WAL_SOCW6111_06_A_EN-CC.mp4
1
*Grace Christ, DSW—Columbia University, School of Social Work
Sadhna Diwan, PhD—San Jose State University, School of Social Work
CHRONIC ILLNESS AND AGING
SECTION 2: THE ROLE OF SOCIAL WORK
IN MANAGING CHRONIC ILLNESS CARE
Grace Christ and Sadhna Diwan*
Synopsis
Managing chronic illness presents a profound challenge to the social work
profession, not only because of the myriad formal and informal services required by the
increasing number of chronically ill elders, but also because the caregivers, too, require
our support and empowerment. As professionals, social workers experience first‐hand
the effects of the met and unmet patient needs, which brings with it a responsibility to
insure that practice and policy decisions give full recognition to the impact of
psychosocial aspects and services that provide total care to chronically ill older adults
and their caregivers.
This section describes some of the most recent literature addressing the role of
social workers in managing chronic illness care specifically related to conducting
biopsychosocial assessments, providing interventions, and in designing and
implementing effective models of health services delivery such as care coordination.
Characteristics of Chronic Illness
as They Impact the Social Work Role
Three important characteristics of chronic illnesses among older adults need to be considered
as they affect the social work role and function.
1. The trajectory for many serious illnesses has changed from an acute terminal
course to a much longer chronic period, with episodes of exacerbations and
remissions interspersed with extended periods of good functioning.
2. The trajectory of advanced chronic and terminal illnesses has changed from a
relatively brief period to a longer period in which both curative and
palliative treatments are combined. Research suggests that a long, advanced
chronic illness can be highly stressful for both patients and their families.
Christ & Diwan Chronic Illness—Role of Social Work
3. The increase in the total number of older people with advanced chronic and
terminal illnesses will require more curative and palliative care being
provided in the home, with greater reliance on provision by family members.
Advances in medical care have changed the illness trajectory in ways that
dramatically alter the older adult’s experience of chronic illness. Facilitating and
enhancing positive health behaviors at all stages of life as well as effective management
of chronic illness is central to the social worker’s role, knowledge, value, and skill base
in health care.
The specific role of social workers in health care is to address psychological,
behavioral, and social factors by (1) assessing patient and family psychosocial health
needs, (2) providing interventions required to address their psychosocial needs and
promote their adaptation to illness and disability, and (3) deve.
Reduce Medicaid Churn with HMS Eliza | InfographicHMS
Check out this infographic about the impact Medicaid churn has on an individual's health and their health plan's bottom line. Member enrollment continuity has positive health and financial outcomes. Reducing the amount of unnecessary churn inflicted on the U.S. healthcare system will not only reduce costs but, also help maintain and improve the health status of many Medicaid recipients like Jane. Follow her story and discover the millions of dollars in healthcare costs saved from a simple HMS Eliza retention program.
1 Grace Christ, DSW—Columbia University, School of Social.docxoswald1horne84988
1
*Grace Christ, DSW—Columbia University, School of Social Work
Sadhna Diwan, PhD—San Jose State University, School of Social Work
CHRONIC ILLNESS AND AGING
SECTION 2: THE ROLE OF SOCIAL WORK
IN MANAGING CHRONIC ILLNESS CARE
Grace Christ and Sadhna Diwan*
Synopsis
Managing chronic illness presents a profound challenge to the social work
profession, not only because of the myriad formal and informal services required by the
increasing number of chronically ill elders, but also because the caregivers, too, require
our support and empowerment. As professionals, social workers experience first‐hand
the effects of the met and unmet patient needs, which brings with it a responsibility to
insure that practice and policy decisions give full recognition to the impact of
psychosocial aspects and services that provide total care to chronically ill older adults
and their caregivers.
This section describes some of the most recent literature addressing the role of
social workers in managing chronic illness care specifically related to conducting
biopsychosocial assessments, providing interventions, and in designing and
implementing effective models of health services delivery such as care coordination.
Characteristics of Chronic Illness
as They Impact the Social Work Role
Three important characteristics of chronic illnesses among older adults need to be considered
as they affect the social work role and function.
1. The trajectory for many serious illnesses has changed from an acute terminal
course to a much longer chronic period, with episodes of exacerbations and
remissions interspersed with extended periods of good functioning.
2. The trajectory of advanced chronic and terminal illnesses has changed from a
relatively brief period to a longer period in which both curative and
palliative treatments are combined. Research suggests that a long, advanced
chronic illness can be highly stressful for both patients and their families.
Christ & Diwan Chronic Illness—Role of Social Work
3. The increase in the total number of older people with advanced chronic and
terminal illnesses will require more curative and palliative care being
provided in the home, with greater reliance on provision by family members.
Advances in medical care have changed the illness trajectory in ways that
dramatically alter the older adult’s experience of chronic illness. Facilitating and
enhancing positive health behaviors at all stages of life as well as effective management
of chronic illness is central to the social worker’s role, knowledge, value, and skill base
in health care.
The specific role of social workers in health care is to address psychological,
behavioral, and social factors by (1) assessing patient and family psychosocial health
needs, (2) providing interventions required to address their psychosocial needs and
promote their adaptation to illness and disability, and (3) developing and implementing
effecti.
1 Grace Christ, DSW—Columbia University, School of Social.docxhoney725342
1
*Grace Christ, DSW—Columbia University, School of Social Work
Sadhna Diwan, PhD—San Jose State University, School of Social Work
CHRONIC ILLNESS AND AGING
SECTION 2: THE ROLE OF SOCIAL WORK
IN MANAGING CHRONIC ILLNESS CARE
Grace Christ and Sadhna Diwan*
Synopsis
Managing chronic illness presents a profound challenge to the social work
profession, not only because of the myriad formal and informal services required by the
increasing number of chronically ill elders, but also because the caregivers, too, require
our support and empowerment. As professionals, social workers experience first‐hand
the effects of the met and unmet patient needs, which brings with it a responsibility to
insure that practice and policy decisions give full recognition to the impact of
psychosocial aspects and services that provide total care to chronically ill older adults
and their caregivers.
This section describes some of the most recent literature addressing the role of
social workers in managing chronic illness care specifically related to conducting
biopsychosocial assessments, providing interventions, and in designing and
implementing effective models of health services delivery such as care coordination.
Characteristics of Chronic Illness
as They Impact the Social Work Role
Three important characteristics of chronic illnesses among older adults need to be considered
as they affect the social work role and function.
1. The trajectory for many serious illnesses has changed from an acute terminal
course to a much longer chronic period, with episodes of exacerbations and
remissions interspersed with extended periods of good functioning.
2. The trajectory of advanced chronic and terminal illnesses has changed from a
relatively brief period to a longer period in which both curative and
palliative treatments are combined. Research suggests that a long, advanced
chronic illness can be highly stressful for both patients and their families.
Christ & Diwan Chronic Illness—Role of Social Work
3. The increase in the total number of older people with advanced chronic and
terminal illnesses will require more curative and palliative care being
provided in the home, with greater reliance on provision by family members.
Advances in medical care have changed the illness trajectory in ways that
dramatically alter the older adult’s experience of chronic illness. Facilitating and
enhancing positive health behaviors at all stages of life as well as effective management
of chronic illness is central to the social worker’s role, knowledge, value, and skill base
in health care.
The specific role of social workers in health care is to address psychological,
behavioral, and social factors by (1) assessing patient and family psychosocial health
needs, (2) providing interventions required to address their psychosocial needs and
promote their adaptation to illness and disability, and (3) developing and implementing
effecti ...
SOCW 04 wk 2 discussion 1 response to studentsLearning Resources.docxwhitneyleman54422
SOCW 04 wk 2 discussion 1 response to students
Learning Resources to be used as references to support your answer.
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Centers for Medicare & Medicaid Services. (2012). Discharge planning. Retrieved from http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Discharge-Planning-Booklet-ICN908184.pdf
Discharge-Planning-Booklet-ICN908184.pdf
Beder, J. (2006). Hospital social work: The interface of medicine and caring. New York, NY: Routledge.
· Chapter 2, “General Medical Social Work” (pp. 9–20)
Craig, S. L., & Muskat, B. (2013). Bouncers, brokers, and glue: The self-described roles of social workers in urban hospitals. Health Social Work, 38(1), 7–16.
Note: Retrieved from Walden Library databases.
Gehlert, S., & Browne, T. (Eds). (2012). Handbook of health social work (2nd ed.). Hoboken, NJ: Wiley.
· Chapter 2, “Social Work Roles and Health-Care Settings” (pp. 20–40)
Judd, R. G., & Sheffield, S. (2010). Hospital social work: Contemporary roles and professional activities. Social Work in Health Care, 49(9), 856–871.
Note: Retrieved from Walden Library databases.
Fox, M. T., Persaud, M., Maimets, I., Brooks, D., O‘Brien, K., & Tregunno, D. (2013). Effectiveness of early discharge planning in acutely ill or injured hospitalized older adults: A systematic review and meta-analysis. BMC Geriatrics, 13, 70.
Note: Retrieved from Walden Library databases.
Marshall, J. W., Ruth, B. J., Sisco, S., Bethke, C., Piper, T. M., Cohen, M., & Bachman, S. (2011). Social work interest in prevention: A content analysis of the professional literature. Social Work, 56(3), 201–211.
Note: Retrieved from Walden Library databases.
Work #1 wanda kinchen (Title of work #1) Answer in APA format with 2 citations per paragraph treat each answer as a separate work or file and each work or file need separate references. Support your posts with specific references to the Learning Resources given in this work. Be sure to provide full APA citations for your references. Treat each work or answer as a separate work and each work needs separate references. Respond to at least two different colleagues’ postings in the following ways:
· Provide a constructive critique of your colleague’s post about the three specific roles.
· Suggest different perspectives of the interventions your colleagues described for the three specific issues.
· Support your post with specific references to the resources. Be sure to provide full APA citations for your references.
Work #1 wanda kinchen
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The three primary roles of medical social workers that I find rewarding are Janitor (cleaning up the mess of others), Glue (adhesive that hold things together) and Challenger (advocating for social change and the well-being .
Evaluating the Effectiveness of Communityand Hospital MedicaBetseyCalderon89
Evaluating the Effectiveness of Community
and Hospital Medical Record Integration
on Management of Behavioral Health
in the Emergency Department
Stephanie Ngo, MD
Mohammad Shahsahebi, MD, MBA
Sean Schreiber, MSED, LPC
Fred Johnson, MBA
Mina Silberberg, PhD
Abstract
This study evaluated the correlation of an emergency department embedded care coordinator
with access to community and medical records in decreasing hospital and emergency
department use in patients with behavioral health issues. This retrospective cohort study
presents a 6-month pre-post analysis on patients seen by the care coordinator (n=524). Looking
at all-cause healthcare utilization, care coordination was associated with a significant median
decrease of one emergency department visit per patient (p G 0.001) and a decrease of 9.5 h in
emergency department length of stay per average visit per patient (pG0.001). There was no
significant effect on the number of hospitalizations or hospital length of stay. This intervention
demonstrated a correlation with reducing emergency department use in patients with behavioral
health issues, but no correlation with reducing hospital utilization. This under-researched
approach of integrating medical records at point-of-care could serve as a model for better
emergency department management of behavioral health patients.
Address correspondence to Mohammad Shahsahebi, MD, MBA, Department of Community and Family Medicine, Duke
University, Durham, NC, USA. Phone: (919) 342-8845; Email: [email protected]
Stephanie Ngo, MD, Department of Community and Family Medicine, Duke University, Durham, NC, USA.
Fred Johnson, MBA, Department of Community and Family Medicine, Duke University, Durham, NC, USA.
Mina Silberberg, PhD, Department of Community and Family Medicine, Duke University, Durham, NC, USA.
Mohammad Shahsahebi, MD, MBA, Northern Piedmont Community Care, Durham, NC, USA. Phone: (919) 342-8845;
Email: [email protected]
Fred Johnson, MBA, Northern Piedmont Community Care, Durham, NC, USA.
Sean Schreiber, MSED, LPC, Alliance Behavioral Health, Raleigh, NC, USA.
Journal of Behavioral Health Services & Research, 2017. 651–658. c)2017 National Council for Behavioral Health. DOI
10.1007/s11414-017-9574-7
Evaluating the effectiveness of community NGO ET AL. 651
Introduction
Background
Patients with behavioral health issues often require more resource-intensive care and are more
likely to be frequent users of health services.1–7 Brennan et al. found that patients with at least one
primary psychiatric visit to the emergency department (ED) were 4.6 times more likely than those
without a primary psychiatric visit to be classified as high utilizers of health services overall, and
that on average, high utilizers with a primary psychiatric visit had a significantly higher number of
ED visits than non-psychiatric high utilizers.7
Furthermore, Bboarding^ of patients with behavioral health issues has become a serious problem
for patients who requi ...
Topics covered in this 10-26-2007 presentation to the TWG include background and brief updates of System
Transformation Initiative projects; a benefits package update, and a housing action plan update.
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The Problem Of Health Care Essay
4-1 Responses 1Healthcare services are always going to be .docxtroutmanboris
4-1 Responses
1
Healthcare services are always going to be needed, and prices will get higher with time; in fact, "Reimbursement just keeps growing over time, say the critics. A Washington Post analysis of records for 5,700 procedures reportedly showed that work RVUs are seven times likelier to increase than to fall" (Baltic, 2013.) The question that is needed to be asked is: What actions can be implemented in order to change and improve the current healthcare problematic? Here are some of the factors that can influence it:
1) Geographic position: The better positioned and available the hospital is, the more consumers can access to health and promote business. There are some other interesting choices that places like Oregon has implemented to help Medicare rates and allow more patient to be seen in community hospitals, which is known as a new Accountable Care Collaborative program "allowing to connect healthcare providers as well as social services and community-based assistance" (Johnson, 2013.)
2) Physician Alignment: Great physicians increase the visit numbers due to high success rates, which contributes to more financial stability and solvency for the hospital.
3) Cost structure: "Hospitals with a high-cost structure either due to high debt, high employee costs or the inability to amortize costs over larger revenues are more susceptible to bankruptcy" (Becker & Dunn, 2010.)
4) Quality of services: low-quality care increase bad reputation, which means no clients for the hospital. High mortality or nosocomial infections equal to poor care as well.
What do you think? Is it necessary to invest more in healthcare workers to increase patient satisfaction? Will that helps the quality of care? What do you think will happen with your cost structure?
Thanks
Reference
Baltic, S. (2013). PRICING MEDICARE SERVICES: Insiders reveal how it's done. Managed Healthcare Executive, 23(11), 28-40.
Becker, S., & Dunn, L. (2010, September 30). 7 Factors to Assess the Sustainability of a Hospital. Retrieved from https://www.beckershospitalreview.com/hospital-management-administration/7-factors-to-assess-the-sustainability-of-a-hospital-assessing-a-hospitals-viability-its-financial-situation-and-the-severity-of-the-threats-it-faces.html
Jonhson, S. R. (2013, September 09). Controlling costs. Modern Healthcare, 43(36), 7-12.
2
When there is more of a demand for health care services, organizations can see that there is more of a need to be cost efficient because there needs to be a balance between the cost that is made when using resources and as well as providing health care to our patients. Instead of breaking even, organizations should consider making revenue so that they can offer adequate pay for staff, allow for departmental growth with expansions and update supplies and technology to be competitive among other hospitals in the area.
As stated in our classroom textbook, Essentials of Healthcare Finance (8th Edition) written by William Cleverley a.
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
Similar to Handout 2 dads provider letter - ad ls (20)
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
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CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
1. 701 W. 51st St. P.O. Box 149030 Austin, Texas 78714-9030 (512) 438-3011 www.dads.state.tx.us
An Equal Opportunity Employer and Provider
COMMISSIONER
Jon Weizenbaum
December 6, 2013
To: Nursing Facility Providers
Subject: Information Letter No. 13-76
Documentation Expectations for Activities of Daily Living
The purpose of this information letter is to clarify supporting documentation requirements for
activities of daily living (ADL) coded in Section G of Minimum Data Set (MDS) 3.0 assessments
for state surveys and utilization reviews.
The Centers for Medicare & Medicaid Services (CMS), the Department of Aging and Disability
Services (DADS) and the Health and Human Services Commission (HHSC) rules and regulations
do not require a nursing facility assign certain staff to complete ADL documentation. Therefore
nursing facility management must determine which staff is assigned to complete ADL
documentation. When making ADL documentation assignments, please keep in mind the MDS 3.0
Resident Assessment Instrument (RAI) Manual notes “Given the requirements of participation of
appropriate health professionals and direct care staff, completion of the RAI is best accomplished
by an interdisciplinary team (IDT) that includes nursing home staff with varied clinical
backgrounds, including nursing staff and the resident’s physician.” (page 1-7)
Nursing facility management also must determine how ADL information is documented. CMS,
DADS and HHSC rules and regulations do not mandate a specific form, format or template for
ADL documentation. For example, use of ADL flow sheets, electronic or paper, completed by
Certified Nurse Aides is acceptable supporting documentation for ADL coding in Section G, as
long as there is no conflicting information in the rest of the clinical record. As noted on page 1-8 of
the MDS 3.0 RAI Manual, “While CMS does not impose specific documentation procedures on
nursing homes in completing the RAI, documentation that contributes to identification and
communication of a resident’s problems, needs, and strengths, that monitors their condition on an
on-going basis, and that records treatment and response to treatment, is a matter of good clinical
practice and an expectation of trained and licensed health care professionals. Good clinical practice
is an expectation of CMS. As such, it is important to note that completion of the MDS does not
remove a nursing home’s responsibility to document a more detailed assessment of particular
issues relevant for a resident.”
Furthermore, when the resident’s level of self-performance or the level of support provided
changes, supporting documentation in the clinical record must accurately describe the change.
Consider the following example:
Two months ago, Ms. Joplin’s ADL flow sheet documented she was independent in bed mobility,
transfer, eating and toilet use. She was not receiving any therapy. In Section G of the quarterly
2. Information Letter 13-76
December 6, 2013
Page 2
MDS assessment completed at that time, her self-performance was coded as a “0” (Independent)
and the ADL support provided was coded as a “0” (No setup or physical help from staff).
Then Mrs. Joplin fell and broke her hip. As required by DADS rules for documenting changes in
condition [Texas Administrative Code Title 40, Section 19.1010(e) (2)], a detailed note describing
the incident/accident was written in the clinical record. After surgical repair in the hospital, Mrs.
Joplin was readmitted to the nursing facility. She was reassessed as requiring extensive assistance
for bed mobility, transfer and toilet use. Her physician ordered physical therapy (PT) services. She
was still able to eat independently. As a result, she was identified as experiencing a significant
change in status that would not return to baseline within two weeks.
Ms. Joplin’s ADL flow sheet documented she required extensive assistance from two staff in bed
mobility, transfer and toilet use. PT notes reflected that she required moderate assistance with
transfer. Nursing staff met with therapy staff and determined that moderate assistance is the PT
term that correlates to extensive assistance in MDS terms and this was documented in the clinical
record. In Section G of the Significant Change in Status Assessment (SCSA) staff completed at
that time, her self-performance in bed mobility, transfer and toilet use is now coded as a “3”
(Extensive assistance). Eating remains a”0”. The ADL support provided for bed mobility, transfer
and toilet use is now coded as a “3” (Two+ persons physical assist). The ADL support provided for
eating remains a “0”. There was no conflicting documentation in the ADL flow sheets, the PT
notes or anywhere else in the clinical record. Documentation in Ms. Joplin’s clinical record
supports the coding in Section G of the MDS.
DADS nursing practices rule pertaining to documentation for nursing facility residents is found in
Texas Administrative Code Title 40, Section 19.1010(e) (2). HHSC utilization review rules for
nursing facilities are found in Texas Administrative Code Title 1, Section 371.212 and Section
371.214.
If you have questions about DADS Texas Administrative Code, call a policy specialist in Policy,
Rules, & Curriculum Development at 512-438-3161. For MDS specific questions, please call the
DADS MDS Clinical Coordinator at 210-619-8010.
Sincerely,
[Signature on file]
Donna Jessee
Director
Center for Policy and Innovation