Nursing audit assists in:
1. Evaluating Nursing care given,
2. Achieving deserved and feasible quality of nursing care,
3. Stimulating better nursing records maintenance,
4. Focuses on patient care provided and not on care provider,
5. Contributes to research in nursing.
Nursing audit assists in:
1. Evaluating Nursing care given,
2. Achieving deserved and feasible quality of nursing care,
3. Stimulating better nursing records maintenance,
4. Focuses on patient care provided and not on care provider,
5. Contributes to research in nursing.
It is defined as the specification of roles and functions of the nature of job of each individual who has to deliver effectively in order to be retained in the institution.
Nursing Audit is a method of quality assurance that involves a detailed review and evaluation of clinical records by qualified professional personnel to evaluate the quality of nursing care.
This Slide is Prepare for B.Sc. Nursing Students. Which help to Understand Recruitment Process in Simple Language.
Contents:
01. Introduction
02. Definition
03. Sources of Recruitment
04. Methods of Recruitment
It is defined as the specification of roles and functions of the nature of job of each individual who has to deliver effectively in order to be retained in the institution.
Nursing Audit is a method of quality assurance that involves a detailed review and evaluation of clinical records by qualified professional personnel to evaluate the quality of nursing care.
This Slide is Prepare for B.Sc. Nursing Students. Which help to Understand Recruitment Process in Simple Language.
Contents:
01. Introduction
02. Definition
03. Sources of Recruitment
04. Methods of Recruitment
Patterns of nursing care delivery in indiaRaksha Yadav
This presentation provides information about the various patterns or systems of nursing care delivery these methods includes case method, functional nursing, team nursing, modular nursing, primary nursing and case management.
The nursing care delivery system means “the process of delivering care to the client by combining various aspects of nursing service which will fit to various patient care settings to produce a common outcome of delivering quality care and meeting the needs of clients”
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
2. Nursing service is the part of the
total health organization which
aims at satisfying the nursing
needs of the patients/
community.
3. PLACEMENT-:
Placement is a process of assigning a
specific job to each of the selected
candidates. It involves assigning a specific
rank and responsibility to an individual. It
implies matching the requirements of a job
with the qualification of the candidate.
4. It improves nurse employee morale
It helps in reducing nurse employee turnover.
It helps in reducing absenteeism.
It helps in reducing accident rates.
It avoids the misfit between nurse and the job.
It helps the nurse to work for the pre determined objectives of the
organization.
5. Assignment refers to “a written
delegation of duties to care for a
group of patients by trained
personnel assigned to the unit.”
6. To delegate the work to be done to the nursing
personnel.
2- To gain the cooperation of the nursing personnel
by knowing and accepting the acceptance of the
work to be done.
3- To organize the work systematically.
4- To prepare and motivate the nurses for delivery
of care.
5- To shoulder accountability.
7. Principles of personnel assignment:
Principles of personnel assignment:
1- Made by the head nurse or nurse in charge for each individual
nurse.
2- Based on:
a- Nursing needs of each patient and approximate time required to
care for him.
b- The capabilities, skill level, previous experience and the interest
of the staff members.
c- Job description.
3- Planned weekly, and revised daily if necessary to assure
continuity of care.
4- Take into account all the direct, indirect and unit activities
5- Consider the geographical location of the unit and the assigned
duties to save nurse’s time and effort.
6- Must be balanced among nursing staff.
7- Never to assign the same task to more than one nurse.
14. DETERMINING THE NURSING
STAFF REQUIREMENT
Calculating staff needs based on the number of beds
in the hospitals.
Estimating the number of staff according to the
degree of dependency of the patients as determined
on a scale.
This method relies on observations of nursing
activity.
15. The amount and quality of teaching.
The amount and quality of supervision and
ward teaching.
The method of appointment of the medical staff.
The plan of ward floor plan.
The physical facilities.
16. The amount, type and location of equipments and
supplies.
The number of working hours
The morale of the worker.
Methods of performing nursing procedures.
The time required for hospital routines
The method of assignment.
The standards of nursing care.
Good ward management.
17.
18. Guide to staffing nursing services
1. Projecting Staffing Needs
Some steps to be taken in projecting staffing needs
include:
1. Identify the components of nursing care and nursing
service.
2. Define the standards of patient care to be maintained.
3. Estimate the average number of nursing hours needed
for the required hours.
4. Determine the proportion of nursing hours to be
provided by registered nurses and other nursing service
personnel
5. Determine polices regarding these positions and for
rotation of personnel.
19. 2. Computing number of nurses required on a Yearly
Basis
1. Find the total number of general nursing hours
needed in one year.
Average patient census X average nursing hours per
patient for 24 hours X days in week X weeks in
year.
2. Find the number of general nursing hours needed in
one year which should be given by registered nurses
and the number which should be given by ancillary
nursing personnel.
a. Number of general nursing hours per year X percent
to be given by registered nurses.
b. Number of general nursing hours per year X percent
to be given be ancillary nursing personnel.
20.
21. The number of beds per unit (one nurse per 4-6
beds) or
The average census of patients per unit (one nurse
per 4 patients).
Example: Days: 45% of the staff
Evenings 35% of the staff
Nights 20% of the staff
The traditional system
23. PATIENT CLASSIFICATION
SYSTEMS
Patient classification system (PCS), which
quantifies the quality of the nursing care, is
essential to staffing nursing units of hospitals
and nursing homes. In selecting or
implementing a PCS, a representative
committee of nurse manager can include a
representative of hospital administration. The
primary aim of PCS is to be able to respond to
constant variation in the care needs of patients.
24. Differentiate intensity of care among
definite classes.
Measure and quantify care to develop a
management engineering standard.
Match nursing resources to patient care
requirement.
Relate to time and effort spent on the
associated activity.
Be economical and convenient to repot and
use.
Characteristics
25. Be mutually exclusive, continuing new item
under more than one unit.
Be open to audit.
Be understood by those who plan, schedule
and control the work.
Be individually standardized as to the
procedure needed for accomplishment.
Separate requirement for registered nurse
from those of other staff.
26. PURPOSES
◘ The system establish a unit of
measure for nursing.
◘ Program costing and formulation
of the nursing budget.
◘ Tracking changes in patients care
needs.
◘ Determining the values of the
productivity equations
◘ Determine the quality
27. TASK QUANTIFICATION.
Focuses on patient needs.
The patients grouped according to their
nursing needs into 3 or more groups:
Group 1: Self care
Group 2: Partial or intermediate care
Group 3: Intensive or total care
28. Classification Categories
Level I-Self
Care or
Minimal Care
-NCH
1.5/pt/day
- Ratio 55:45
-Can take a bath on his own; feed himself; perform his
own ADL.
-For discharge pt; non-emergency, newly admitted
don’t exhibit unusual s/s;
- requires little treatment and observation
Level II –
Moderate
Care or
Intermediate
Care
-NCH 3/pt
- Ratio 60:40
-Need some assistance in bathing, feeding, ambulating
for short period.
-Extreme s/s of illness must have subsided or have not
yet appeared
-May have slight emotional needs
-v/s taking ordered 3x/shift; with IVF/BT; are semi-
conscious and exhibiting some psychosocial or social
problems;
- periodic treatments and/or observations and
/instructions
29. Classification Categories
Level III –
Total,
Complete or
Intensive
Care
-NCM
6hrs/pt/day
-Ratio 65:35
-Patient are completely dependent upon
the nursing personnel.
-They are provided complete bath, are
fed, may or may not be unconscious,
with marked emotional needs; with v/s
monitoring more than 3x/shift
-Maybe on continuous oxygen therapy,
with chest or abdominal tubes
-They require close observation at least
every 30 minutes for impending
hemorrhage, with hypo or hypertension
and/ or cardiac arrhythmia
30. Classification Categories
Level IV-
Highly
Specialized
Critical Care
-NCH 6-9 or
more /pt/day
- Ratio 70:30
or 80:20
-Need maximum level of nursing care
with a ratio of 80 professionals to 20
non-professionals.
-Needs continuous treatment and
observation
-With many medications, IV piggy
backs; v/s monitoring every 15-30
minutes; hourly output.
-There are significant changes in
doctor’s orders
33. Patient Care
The registered nurse plans,
organizes, and performs all care
Registered
Nurse
8-hour shift
Registered
Nurse
8-hour shift
Registered
Nurse
8-hour shift
Total Patient Care (Case Method) Delivery
34. one professional nurse
assumes total
responsibility of
providing complete
care for one or more
patients (1-6) while
she is on duty. This
method is used
frequently in intensive
care units and in
teaching nursing
35. • Advantages
• High degree of autonomy
• Lines of responsibility and accountability are
clear
• Patient receives holistic, unregimented care
• Disadvantages
• Each RN may have a different approach to care
• Not cost-effective
• Lack of RN availability
37. Advantages:
•Care is provided economically and
efficiently
•Minimum number of RNs required, so it is
efficient when there is a shortage in the
staff or there is limited number of
professional nurses
•Tasks are completed quickly
•Useful in emergency situations.
38. Disadvantages:
Care may be fragmented
Patient may be confused with many care
providers
Caregivers feel unchallenged
Lack of communication among the different
persons who care for the patient.
Neglecting the humanity of the patient and
the individual needs of the patient will be los
in an effort to get the work done.
39. Nurse Manager
RN Team Leader
RN
LPNs/LVNs
Nursing Assistants
RN Team Leader
RN
LPNs/LVNs
Nursing Assistants
Assigned Patient Group Assigned Patient Group
Team Nursing Model
40. Geographic
Patient Unit
Patient Care
Team:
RNs
LPNs/LVNs
Nurse Aides
Meds
Supplies
Linens
Geographic
Patient Unit
Patient Care
Team:
RNs
LPNs/LVNs
Nurse Aides
Meds
Supplies
Linens
Geographic
Patient Unit
Patient Care
Team:
RNs
LPNs/LVNs
Nurse Aides
Meds
Supplies
Linens
Nurse Manager
Modular Nursing Model
41. Modular nursing
Modular nursing is a modification of team
nursing and focuses on the patient‘s geographic
location for staff assignments. The concept of
modular nursing calls for a smaller group of staff
providing care for a smaller group of patients.
42.
43. . MODULAR NURSING:
Modular nursing assignment is used when the
nursing staff includes technical and nurse aides,
as well as professional nurses. Although two or
three persons are assigned to each module, the
greatest responsibility for the care of assigned
patients falls on the professional nurse. The
professional nurse is also responsible for guiding
and teaching non-professional nurse.
44. Advantages
Continuity of care is improved.
RN more involved in planning and
coordinating care.
Geographic closeness and efficient
communication.
Disadvantages
Increased costs to stock each module.
Long corridors not conducive to modular
nursing.
45. Primary nursing:
It is also called relationship based nursing. It
involves total nursing care, directed by a nurse on
24 hour basis as long as the client is under the
care.
46. Primary Nurse
24-hour responsibility for
planning, directing &
evaluating patient care
Patient
Associate Nurses
Provide care
when primary
nurse is off duty
Physician and
other members
of the health care
team
Primary Nursing Model
47. Merits:
opportunity for the nurse to see the client and family as one
system.
Nursing accountability, responsibility and independence are
increased.
The nurse is able to use wide range of skills, knowledge and
expertise.
potentiates creativity by the nurse and thereby work
satisfaction increases
increased trust and satisfaction for both
48. Demerits:
The nurse may be isolated from the
colleagues.
Little avenue for group planning of care.
Nurse must be mature and independently
competent.
It must be cost effective.
49. NURSE CASE MANAGER
Assesses, plans, implements, coordinates,
monitors, and evaluates patient care
options and services to meet health needs
Onset of
Illness
Resolution of
Illness
Collaborates with Nursing,
Physicians, Physical/Speech/
Occupational Therapists, Dietary,
and Ancillary Services
Collaborates With
Patient and Family
Coordinates Services:
Home Care, Hospice,
Extended /Long-term Care
Ambulatory Care Services
Nursing Case Management Model
50. CASE MANAGEMENT MODEL
• Case management is a process of monitoring an
individual patient’s health care by the case manger,
for the purpose of maximizing positive outcomes
and containing costs. The case manger has
graduate-level preparation or is at an advanced
level of nursing practice. The case manager role
requires not only advanced nursing skills but also
advanced managerial and communication skills.
54. Advantages:
For the patient: -
• Establishing and achieving a set of “expected” or
standardized patient care outcomes for each patient.
• Facilitating early patient discharge or discharge within
an appropriate length of stay.
• Using the fewest possible appropriate health care
resources to meet expected patient care outcomes.
• Facilitating the continuity of patient care through
collaborative practice of diverse health professionals.
For the nurse: -
• Enhancing nurse’s professional development and job
satisfaction.
• Facilitating the transfer of knowledge of expert
clinical staff of novice staff.
55. Disadvantages:
• Some experts are argued that this role should be
reserved for the advance practitioner nurse or an
RN with advanced training or need 3 to 5 year
experience.
• The case manger should also be extremely bright,
have well developed interpersonal skills, be able
to multitask, have a strong foundation in
utilization review, and understand payer-patient
specifics and hospital reimbursement
mechanisms.
56. DIFFERNTIATED NURSING PRACTICE
• Differentiated nursing practice refers to an
attempt to separate nursing practice roles based
on education or experience or some
combination of both.
57. • Education model:
Role differentiation based upon type of
educational preparation [BSN, MSN etc]
• Competency model:
Role differentiation based on individual
nursing skills, expertise, experience etc.
58. Merits:
• match patients needs with nursing
competencies.
• efficient use of nursing resources.
• Provide equitable compensation
• It increase nurse satisfaction, built loyalty
and increase the prestige of the nursing
profession.
59. a prominent characteristic among the new models
being tried is the nurse as a clinical expert
leading other members of the team partners.
60. Analyse nursing
needs of patient and
skill of person.
Prepare monthly,
weekly and daily
time table for
S/Nurses.
give teaching and
guidance to juniors.
Evaluate personnel.
Maintain inventories,
requisting for
supplies and
services.
Assign tasks to
nurses.
Coordinate with
other departments
for effective patient
care.
Gain co-operation
from subordinates
and supervisors.
Delegate
responsibility for
patient care.
61. Managing, supervising and assisting the nursing staff, as well as providing
administrative support and patient care.
Assigning nurses and support staff to patients
Develop and implement training courses and organize seminars to help
educate and train new nurses and staff.
Document the performance of nurses, perform evaluations and counsel
nurses on unsatisfactory performance.
Creating schedules, maintaining adequate supplies and informing staff of
changes to protocol.
Role of nurse managers
62. Promotes and maintains harmonious and effective
relationship with the various administrative departments
of the hospital and related community agencies.
Initiates the confidential reports of nursing staff on due
dates.
Responsible for organizing and conducting staff meeting of
the nursing staff once in three months.
Ensure that a standard of discipline of nursing staff is high
at all times.
63. Lack of adequate
training
Problem of
personnel
management
Inadequate
number of
nursing
staff
Shortage of
trained
manpower
No involvement
in planning.
No autonomy
in nursing
activities.
PROBLEMS AND CHALLENGES
64. RESEARCH ARTICLES-:
1.The nurse-patient assignment: Purposes, decision factors and steps of the
process by Allen, Stephanie Brodack, Ph.D., UNIVERSITY OF SOUTH
CAROLINA, 2012,
The purpose of this exploratory descriptive study was to describe the nurse-
patient assignment process. Specifically, this study sought to identify
purposes, decision factors and steps of the process. Fourteen Nurse
Managers representing 11 nursing units of a suburban hospital in the
Southeastern United States were interviewed using a semi-structured
interview guide. The data was analyzed using Krippendorff's method of
content analysis. Results were presented in narrative and Venn diagram
form. The most common decision factors associated with the nurse-patient
assignment process were related to patient and nurse demographics, acuity,
proximity, competence, workload, nurse-patient ratio, collegiality and
staffing. Three pathways to making nurse-patient assignments were
described that corresponded to the type of nursing unit (episodic care, acute
care/short stay and long stay) on which they worked. For example, Nurse
managers on long stay units divided patients into groups then assigned the
nurse to a group of patients. Secondary findings indicated that nurse-patient
assignment process variations existed across the three unit types related to
purposes, decision factors, and steps of the nurse-patient assignment. For
example, the purposes discharge planning and care coordination were
identified only by Nurse Managers on long stay units.
65. 2. The Association of Registered Nurse Staffing Levels and Patient
Outcomes: Systematic Review and Meta-Analysis
Kane, Robert L. MD et al Medical Care:December 2007 - Volume 45 - Issue
12 - pp 1195-1204 conducted a studyTo examine the association between
registered nurse (RN) staffing and patient outcomes in acute care
hospitals. . An increase by 1 RN per patient day was associated with a decreased
odds ratio of hospital acquired pneumonia (OR, 0.70; 95% CI, 0.56–0.88), unplanned
extubation (OR, 0.49; 95% CI, 0.36–0.67), respiratory failure (OR, 0.40; 95% CI, 0.27–
0.59), and cardiac arrest (OR, 0.72; 95% CI, 0.62–0.84) in ICUs, with a lower risk of
failure to rescue (OR, 0.84; 95% CI, 0.79–0.90) in surgical patients. Length of stay was
shorter by 24% in ICUs (OR, 0.76; 95% CI, 0.62–0.94) and by 31% in surgical patients
(OR, 0.69; 95% CI, 0.55–0.86).
Studies with different design show associations between increased RN staffing and
lower odds of hospital related mortality and adverse patient events. Patient and
hospital characteristics, including hospitals’ commitment to quality of medical care,
likely contribute to the actual causal pathway.
66. Yu-Chih Chen et al (2013) did a quasi experimental study on Effectiveness of
nurse case management compared with usual care in cancer patients at a
single medical center in Taiwan:
This study was conducted with a quasi-experimental design in a national
medical center in Northern Taiwan. A total number of 600 subjects randomly
selected from the cancer case management system enrolled in the case
managed group, and 600 patients who received usual care were randomly
selected from cancer registry and enrolled in the control group. The study
instrument was developed to measure care effectiveness, including the rates of
patient continuing treatment, non-adherence to treatment, prolonged
hospitalization, unplanned readmission, and planned admission for active
treatment.
Researcher concluded that cancer case management could improve the
effectiveness of cancer care services and concretely illustrated a
comprehensive model for oncology patients in Taiwan and suggested for further
investigation.
69. Instruct the staff
nurse to stay on
patients left side
to help in
patient’s
examination.
Remember and
report
observation to
doctor.
record orders/get
them written by
doctors.
After the ward
Round:
• Instruct staff nurses
to carry out orders
• Observe patient
carefully.