Rajni's Blog Review

I read Rajni's blog in regards to TB. I am also shock to discover that the USA does not have a preventative solution as does the third world countries. It is very disturbing to know that the USA is so far behind other countries. I also found it educational to know that you can get TB from flying on an airplance, but it does make sense; considering all the amount of people that be on one flight. TB is an interesting disease within itself because its communicable and their is really no way to protect yourself unless you live your live walking around with a full body germ suit on that can prevent you from breathing everybody air and to stop skin contact.

Working With Your Child's School

The quality tool that I picked for this week is related to Caring for Children with ADHD: A Resource Toolkit for Clinicians. I founded it interesting to know that most parents discover thier child is ADHD by a teacher from school. I learned that the correct method as to diagnosis a child with ADHD is to talk to both the parent and the teacher while examining the child's behavior. I learned some interesting tips that would help your child cope better with ADHD and perfoming well in school. The most important one to me was to praise your child for good work; however, I believe parents should do that regardless if their child has ADHD or not. I have learned that jusy by praising your child for doing good that will eliminate them doing bad in most cases.


Caring for Children with ADHD: A Resource Toolkit for Clinicians
http://www.nichq.org/NICHQ/Topics/ChronicConditions/ADHD/Tools/ADHD.htm

Continuous Quality Improvement

My topic for this week is related to the continuous quality improvement. I chose this topic because it was very educational to me. I think that this acronym that the company has came up with is very beneficial and educational. FOCUS which means

Find a process to improve

Organize to improve a process

Clarify what is known

Understand variation

Select a process improvement

I thought that this may help some students that may be having difficulities grasping the CQI concept.

How to Establish a Palliative Care Program

http://64.85.16.230/educate/content/development/cqi.html

Ramona's Blog Review

I agreed with Ramona in regards to her views on nosocomial infections.

How to Spot A Failing Project

After hearing about how many project fails, I decided to do a little research on the matter. I found it interesting that only 1/3 of all projects are successful. I also found out that if your project budget is under 750,000 your success rate is higher; however, if your project budget is over millions of dollars your failure rate is higher. This article talk about ways that will help you identify when a project is failing. Two important factors to me was finding out that temembers working overtime means that thier is a problem. Because no project should have overtime and the other interesting indicator was weight loss. If you notice members on your team have been losing weight, then you can bet its because of their long night working while eating junk food and drinking caffeine. I was very shock to find out how many ways an unsuccessful project can affect the human body. If you are interested in finding out more ways to identify a project that heading for failure than you should read this article.

http:..www.cio.com/article/print/124309

Women's Health USA 2007: Medication Use

I chose medication usage during women throughout their lifetime for my quality tool. I found it very interesting to know that most women suffer from respiratory problems and are prescribed medication during their young years and decrease with age. I owuld think that the older you get the more respirator problems you would have. I was also very shock to learn that women between ages 45-64 years suffer from antidepression and are prescribed the most medication during this time period. In regards to children under 15 years of age, they are prescribed the most drugs for respirator problems. However, in adults in general most drugs are prescribed to patients who suffer from cardiovascular/renal sympotms and just pain relief drugs in general.

Http://mchb.hrsa.gov/whusa_07/healthservutiliz/0409mu.htm

Allison's Blog Review

I enjoyed Allison's article because I failed victim to adverse drug effect. My doctor prescribed me the wrong drug and as a result I ended up with damage done to my stomach. I think that doctors should take more then "5-10 minutes" to decide on whether that medicine will be good for the patient. I know in my case the doctor didn't listen to anything that I had to say and he prescribed my medicine based on what he thought was best and not on what was in my record and what I was saying. I think there should be more safety precautions when it comes to drugs.

Workplace Violence: Raising the issue and spotting the red flags

This article deals with ways to prevent workplace violence from happening in your facility and it also states what should be done if it does happen in your facility. It is very important to have in documentation what will happen to an employee who decided to bring violence into the facility. It also states that the boss should have a plan in order for an employee who spouse or outside person who brings violence into the facility. It is very important to plan for these events ahead of time instead of brushing them off as if it cannot happen within your facilty. I have learned through reading and watching the news that workplace violence can happen anywhere because you never know what another person is thinking nor what that person is capable of doing so you should always have a plan in action for the "what if's." This article states that if you have people within your facility that appears to stay bothered or fearful then you should document that person as being a potention threat to the facility. Now I am unsure of how that will work because I know some people may just be scared until they become use to the environment; however, on the other hand I do believe it is a good idea to document anybody that you think is a potential hazard to the company just in case they are and something bad does happen. I think precaution before is better then waiting till after it has occurred.

http://www.bizjournals.com/washington/stories/2006/02/06/smallb1.html

Child Abuse Identification Toolkit for Professionals

This week for my quality tool I decided to research sexual abuse in children. I decided on this topic because alot of children are affected by this type of abuse and alot of adults can't identify the symptoms. Mothers need to be careful with whom they leave their children with and this includes the child's father because facts prove that most perpetrator is often a male family member, family friend, or neighbor who has access to the child or has authority over the child. A prime example is today's breaking news-a father molested and allowed two of his friends to rape his 3 year old daughter. I did not know that lices were a good indicator for sexual abuse. Facts state that lice in eyelashes prompt an ivestigation of sexual abuse as only pubic lice infest the eyelashes. Mothers need to become more aware of their children behaviors around certain people and educate their child on sexual abuse. This article provides many tips on how to identify and prevent your child from being a statistic.

http://www.cincinnatichildrens.org/assets/0/78/1067/1395/1577/1611/0823d7bd-f10e-41f3-8fe3-047bda22faf1.pdf

Charlene's Blog Review

I agree with Charlene's view on her article, Treating Tobacco Users. I think that phsyician should try to establish a program for their patients who have serious health issues due to tobacco usage because they can obvious see that the patient cant do it on their own. I also believe that they should provide and educational class for the family because alot of people do not know that second hand smoke is worse then first hand smoke.

HPV Vaccine Information for Clinicians

I chose this quality tool because I wanted to be educated on the n ew vaccine that's out for female called Gardasil. 12,000 women are diagnosed yearly with some type of cervical cancer and nearly 4,000 dies out of that population. I learned that the vaccine works best in females before they become sexually active; therefore, its recommend for girls age 9-15 to get the shots early in life. The catch up vaccine is recommend for females who are already sexually active. Its said to be protect again four types of hpv 16, 18, (cervical cancer) and 6, 11 (genital warts). Its said that a person can still receive the vaccines even if they have one or had on type of hpv because the vaccine will protect against the other types. I found it interesting to know that males are only affectd by 1% and that they are currently developing a vaccine for males. I also learned that cervical cancer claims the most lives in American women in the U.S. It was also shock to know that this is a drug that safe for pregnant women even though its not recommend that pregnant women get the vaccines. I think that this is something very important that all women should talk to their OB/GYN about. This vaccine can be free in females 18 and younger that has some type of medical coverage, even if the female dont have coverage through vaccines for children.

Centers for Disease Control and Prevention, HPV Vaccine Information for Clinicians
http://www.cdc.gov/std/hpv/STDFact-HPV-Vaccine-hcp.htm

Thyroid Disease: 10 Thyroid Mistakes Your Doctor Maybe Making

I chose this article becausae it discussed alot of topics that we have covered in our previous chapters. I found it very interesting to know that most doctors that don't know how to treat a patient with a certain disease will tell them a lie. For example, number 8 states that a pateint should never let a physician tell them that they only prescribe a certain type of drug. If you have that type of doctor then its best you change physician because that physicisn isn't educated enough about your condition. This article also deals with physicians not educating the patient enough on how to take a prescribtion which results in a possible medical error and because of that the patient can suffer from a adverse drug reaction. This article also touches on how certain doctors thing they know what's wrong with the patient instead of hearing the patient side and I find that very interesting becauset he whole point is for the doctor to listen to the patient and together come up with a treatment plan. Another interesting fact is that scares me is how doctors don't perform all the test they need on a patient symptoms to come up with a diagnosis. That scary because their are people who sick and know they are sick and being mistreated due to misdiagnosis because physician arrogrance.

About.com, Thyroid Disease, 10 Thyroid Mistakes Your Doctor May Be Making,
http://thyroid.about.com/cs/doctors/a/10mistakes.htm?p=1

Review of Kim's Blog

I reviewed Kim's blog and I found it very interesting to know the main types of injuires. I agree with her in stating how helpful it was to learn about injuries done to the eyes resulting from dust and flying debris. I found it very amazing to know that the smallest things such as dust can cause a major problem to the eyes becasue of their sensitivity. I also can agree with her about the damage done to the ears showing up later in life that's why I believe it to be very important for schools and facilites to run hearing test on all students, patients, and staff members.

Exposure To Sunlight May Decrease Risk of Advanced Breast Cancer by Half

I decided to do my article on decreasing risk of exposure. I found an article that was educational to me. The article was about how exposure to sunlight may decrease the risk of advanced breast cancer. I found it educational to know that vitamin D may be important in slowing the growth of breast cancer cells in women. I found it very interesting to know that it also depends on your skin pigmentation level as to how effective the exposure would be. However, there is a catch so women shouldnt try to reduce their chances of developing breast cancer by over exposing their body to sunlight because you may develop another type of cancer called sun-induced skin cancer. Therefore, I thought it would be beneficial to list other ways of increasing your vitamin D intake, multivitamins, fatty fish and fortified food; and certain cereals and fruit juices.

Science Daily; Exposure To Sunlight May Decrease Risk of Advanced Breast Cancer By Half;
http://www.sciencedaily.com/releases/2007/10/071018171424.htm

What You Should Know About Stroke Prevention

The quality tool that I selected for week 6 is related to stroke prevention. I have been educated about strokes prior to this article, but I was always curious to know the damage it causes its victims. I use to wnder how come a patient would die from a heart attack quicker than they would from a stroke. I thought that since the brain was a vital part to the body that if you has a stroke or a heart attack and the people who suffered from a heart attack always seemed to be better off. People who suffered from a stroke would be left paralyze on one side and that same side would be disconfigured and I always use to wonder why. For those who aren't familiar with strokes, a stroke occurs when blood flow to the brain is blocked; either by narrowed blood vessels or blood clots or bleeding in the brain. Brain cells begin to die within minutes, if they are deprived of needed nutrients which in return can count for disconfiguration of body parts. A person suffering from vision and sensory loss, problems with walking and talking, or difficulty in thinking clearly. The warning signs for a stroke includes sudden numbness or tingling feeling to one side, slurred speech blurred vision, stumbling or clumsiness which most people take lightly or think that something else is wrong. The biggest problems with prevent strokes, is ignoring the symptoms. Therefore, people need to stop ignoring because the best medicine is prevention!

Agency for Healthcare Research and Quality; What You Should Know About Stroke Prevention; http://www.ahrq.gov/consumer/strokcon.htm

Amanda's Blog Review

I liked the article that Amanada chosed because I believe that the list is very important and well needed in certain people lives. Its very beneficial for parents that have children on alot of medications. I like the idea that the list includes the physician name and number, pharmicst name and number; and a 24 hour pharmacy. That's way if a problem comes up regarding the medicine or dosage, the person will have quick access to the information. It is also a good thing for baby sitters who have to watch over children or the elderly who may be taking multiple medications. I just believe that it's a good idea in general.

Fetal Alcohol Spectrum Disorders

The quality tool that I decided to talk about this week is about Alcohol abuse during pregnancy. The technical term is called Fetal Alcohol Specturm Disorders. It affects the fetus development of skeletal structures, organs, the nervous system and over all growth. I knew that alcohol could harm the fetus but I didn't know that it had such a serious impact. I thought that street drugs caused more harm to the fetus than alcohol. Many people don't think that alcohol can damage their child during pregnancy because they are informed wrong. Most people are under the impression that alcohol leave the system within 24 hours; therefore, they don't believe theirs any damage done to the baby.


Drinking and Reproductive Health, A Fetal Alcohol Spectrum Disorders Prevention Tool Kit
http://www.acog.org/departments/healthIssues/FASDToolkit.pdf

Infection Control Across the Continuum of Care

This article discuss the continuum of care by handwashing to prevent infectious diseases. I knew that it was important to wash your hands, but I didn't know how much of an impoact it has on disease control. I found out just how important it is to wash your hands, by learning that the Centers for Disease Control and Prevention have developed a new method for hand sanitization. I learned that if you wash your hands with a hand sanitizer that includes mositurizers you will increase your prevention of infection. I was shock to know that in certain areas and at certain facilities that caregivers and staff members are required to wear a mobile hand sanitizers device while providing care. I, also, learned that in long-term care facilities all staff members have to pass a test for hand washing and hand sanitization inorder to be employeed, and remain employeed after being hired. I found it very interesting to know that just by keeping your hands clean that you can prevent the body from many infections that you would never believed came from your hands


ECPN Clinical and Financial Strategies for the Extended Care Professional, Feature: Infection Control Across the Continuum of Care
http://www.extendedcarenews.com/article/1266

Ramona's Blog Review

I reviewed Ramona’s blog and I agree with her in saying that we should be ready for all type of people during a disaster because all types of people flock to a different location during a disaster. Just by volunteering in helping create databases I have seen the wide variety of people. Not only is it hard to deal with elderly people who suffer from dementia but it’s even harder to deal with scared children and depressed teens, also types of people who flocks. I believe that more people should volunteer during a disastrous time in order to learn to deal with different personalities and diseases.

Meeting Minutes

I found taking minutes to be very interesting during our class discussion and I wanted to know the effective way to take minutes because of how far you can go in a business just by taking great minutes during meetings. The article I found related to taking minutes during a department meeting for the Department of Consumer Affairs. They reporter took records on everything that went on during the meeting and she discussed objectives that were discussed during the last minute and had not had any follow-up activity. I found it interesting how they did their budgeting plan and who all had an input and who was the final decision maker. I liked the layout and format of this report because it was easy to read and follow each member suggestion and it included everybody in the meeting. I would like to get the experience in taking meeting just to find out how good I would be at it.


Board of Behavioral Sciences: Meeting Minutes

The Heart Truth for African American Women: An Action Plan

I selected this article because I wanted to become educated on heart disease, considering the fact hat it is the number one killer among women in the United States. I learned that out of all of the women affected by heart disease, African Americans women are at the top of the list. Even though, we are affected the most by the disease we can decrease our rate by 82% just by creating and living a healthier lifestyle. In case you are wondering, a heart disease is a disorder of the blood vessels of the heart that can lead to a heart attack. I found it very interesting to know that women 55 years and older have an increase chance of developing heart disease because after menopause the body no longer produces estrogen. For some reason, I did not know that estrogen had anything to do with heart disease. The leading causes of heart disease are smoking, high blood pressure, high blood cholesterol, obesity, physical inactivity, and diabetes. I thought that diabetes would have the greatest impact on the disease; however, I was wrong. Smoking has the greatest impact and if you can stop smoking you decrease your risk by more than half.

U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. The Heart Truth: Women & Heart Disease

Review of Allison's Blog

I reviewed Allison’s blog on Nutrition Care Alerts: Warning Signs & Action Steps for Caregivers in Nursing Facilities. I agree that the nurse should report all observations of the patient’s care. It should be documented for medical rules and policies but also for patient knowledge and family awareness. A lot of nursing home patient’s relatives like to know what’s going on with the love one that they have in the home and having documentation of step-by-step observation will keep down a lot of confusion between the relative and the nursing staff. I also agree that more people should be aware of how to treat a patient. For example, if a patient’s primary nurse isn’t there to help aid the patient then another nurse or family member should be able to assistance that patient because a lot of problems will occur if the patient is without something vital due to staffing absences.

Essentials of Public Reporting of Healthcare-Associated Infections: A Tool Kit

I have become very interested in medical errors and reporting of medical errors that I found a quality tool that addresses a similar issue, reporting infections. This article is about the publication of healthcare-associated infections (HAIs). Did you know that the reporting of infections disease does not have a standard rule to follow? I didn’t know that. I thought that there were rules and policies for everything. I have learned that the legislative is now trying to develop a standardized approach to help aid in more accurate reporting of HAIs. They are getting the state, infection prevention, risk management; and healthcare epidemiology all involved in developing a better method for reporting HAIs. Did you know that HAIs is a major public health problem in the USA affecting 5 to 10 percent of hospitalized patients annually, resulting in 2 million infections, 90,000 deaths and adding $4.5 to $5.7 billion in healthcare costs? I had no idea because I only thought that infectious-communicable diseases had to be reported annually not healthcare-associated infections. No one knows why theirs a problem with reporting HAIs but its believed to be because of the time frame the reports go out. Half believe it should be quarterly to dismiss any records that are out-of-date and half believe it should be annually to assure robust denominators and stable rates. I personally do not know enough to determine whether it should be quarterly or annually but I do know that whichever one will eliminate the problem of inaccurate reporting is the one they should go with.

Healthcare-Associated Infection Working Group of the Joint Public Policy Committee
Essential of Public Reporting of Healthcare-Associated Infections: A Tool Kit
http://www.cdc.gov/ncidod/dhqp/pdf/ar/06_107498_Essentials_Tool_Kit.pdf

The Sorry Works! Coalition: Making the Case for Full Disclosure

One of the biggest hidden secrets in the medical industry is becoming the hottest topic in law firms all around, medical errors. I became very interested in medical errors after watching the video in class related the same matter. I found an article about an established group, Sorry Works, that’s dedicated to making the process better for physicians, patients, and victims; if possible. “The Sorry Works Coalition, an organization of doctors, lawyers, insurers, and patient advocates that is dedicated to promoting full disclosure and apologies for medical errors as a ‘middle-ground solution’ to the medical malpractice crisis.” I was very shock to know that when a doctor or nurse makes a mistake that they try to hide it. I was under the impression that if a mistake occurred under medical staff then they would admit their fault and have no problem in doing so. However, I have learned better. I found out that the physicians use to follow a method called “deny and defend.” This method failed because it angered the victim’s family even more and resulted in more lawsuits and it gave the facility a bad representation because it gave off the impression that a cover up was involved. They are now trying to change the old process and develop a new process where the medical staff admits their mistake and apologize to the family and try to make the situation better for future patients. What shocked me the most out of the whole article was the statement a lawyer made “if a doctor apologizes for an error and offers compensation, but the compensation is rejected, and a lawsuit is initiated. So, the doctor will go to court, looking like the person who tried to do the right thing by apologizing and making a fair offer but was rebuffed.” I am left wondering is that really what goes on during these lawsuits. How dare the doctors be portrayed as the victims while the real victims are left out alone! I believe that more hospitals should adopt the Sorry Works Coalition at their facilities.

Joint Commission
Journal on Quality and Patient Safety: The Sorry Works! Coalition: Making the Case for Full Disclosure
http://www.jointcommission.org/NR/rdonlyres/5E597FEF-6F86-480D-A1E2-CDD6CB491D3E/0/Sorry_Works.pdf

10 Patient Safety Tips for Hospitals

This article was created to help improve hospital safety. I thought that number 3, limit shifts for hospital staff, if possible, was interesting because involves cut back in employees hours. Many medical errors occur because the patients are tired and over-worked. This article states that at some Boston hospital(s) there has been a decreased by 36% in medical errors just by eliminating employees work load. Number 9, limit urinary catheter use to 3 days, was educational to me because I didn’t know that there are software programs available that will notify the physician when it is time for a change. By having computer-based software for reminders, the hospital decreased its rate in urinary tract infections from patients with catheter. Number 5, prevent central line-related bloodstream infections, was another education tip for me. The five evidence-based procedures includes hand-washing, using full-barrier precautions during the insertion of central venous catheters, cleaning the skin with chlorhexidine, avoiding the femoral site, and removing unnecessary catheters has reduced deadly infections to zero in a study perform in small and large hospitals. I just believe that that’s remarkable to reduce a rate of infection down to zero. This article talks about a lot of ways to better and improve your hospital but the one that I found to be the best and that will eliminate a lot of medical errors is number 2, build teamwork. A hospital cannot function well if there isn’t teamwork. All staff needs to come together, communicate, listen, and most importantly pay attention to everybody and everything and the flow should go a lot smoother. TeamSTEPPS was developed just to help improve teamwork within a facility.

10 Patient Safety Tips for Hospitals http://www.ahrq.gov/qual/10tips.htm

Breaking the Code

Delinquent Medical Records

One of the biggest difficulties within all healthcare facilities is keeping down the delinquent medical records rate. This article gives you about a solutions that the University of Utah HIM division put together to help them stay above water, when it comes down to meeting the standard rates. One of their approaches that interested me the most was the direct financial incentive. This approach either pays you cash or deducts cash from you based on how many delinquent rate charts you complete. The residents within the facility are rewarded $5 for every chart dictated within 24 hours of discharge/procedures and penalize $10 for every delinquent chart over seven days. Another method that I found interesting was the strictness of the medical chief of staff. The chief uses his authority to suspend admitting privileges of physician(s) who have delinquents chart out at 22 days, as opposed to the standard rule of 30 days. The final method that caught my eye was the use of the students in the work-study program. They use a software system to match the student that will be beneficial to them in maintaining documents and filing them. I believe that if more hospitals incorporate some of the methods that the University of Utah HIM division has developed that they would see improvement within their facility delinquent rate.


Military Medical/NBC Technology Online Archives: Breaking the Code
http://www.military-medical-technology.com/article.cfm?DocID=178