systems-based solutions in acute care

Description/Paper Instructions

Question 1

In acute care, a charge nurse is assigned to oversee a unit, and a nursing supervisor oversees the nursing role across a facility. All work together to control the flow of patients in and out of the unit and facility, make staffing assignments, and assist with problems and crises.

Consider this situation: A nurse is dealing with a crisis for one patient and misses a second patient crisis–a young woman who died from a postoperative hemorrhage. In this tragic situation, competing crisis events on the unit prevented a nurse from adequately monitoring other assigned patients on the unit.

The charge nurse and nursing supervisor stated in the Board of Nursing’s investigation of the event that they depended on the individual nurse to alert them if help was needed.

Question: Discuss systems-based solutions that could have prevented this event.

Question 2

List three questions that are solely influenced by the quality of nursing care.  List three questions that are collaboratively influenced by the quality of nursing care?  Based on your observations in clinicals, what are some systems-based issues that have an impact on the quality of nursing care measured by the HCAPHS survey?

Attached Is the HCAPHS survey

RUBRIC

HCAHPS Survey

SURVEY INSTRUCTIONS

• You should only fill out this survey if you were the patient during the hospital stay named in the cover letter. Do not fill out this survey if you were not the patient.

• Answer all the questions by checking the box to the left of your answer.

• You are sometimes told to skip over some questions in this survey. When this happens you will see an arrow with a note that tells you what question to answer next, like this:
• Yes
• No ^è If No, Go to Question 1

You may notice a number on the survey. This number is used to let us know if you returned your survey so we don’t have to send you reminders.

Please note: Questions 1-25 in this survey are part of a national initiative to measure the quality of care in hospitals. OMB #0938-0981

Please answer the questions in this survey about your stay at the hospital named on the cover letter. Do not include any other hospital stays in your answers.

YOUR CARE FROM NURSES

1. During this hospital stay, how often did nurses treat you with courtesy and respect?

2. During this hospital stay, how often did nurses listen carefully to you?

3. During this hospital stay, how often did nurses explain things in a way you could understand?

4. During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?
5. During this hospital stay, how often did doctors treat you with courtesy and respect?

6. During this hospital stay, how often did doctors listen carefully to you?

7. During this hospital stay, how often did doctors explain things in a way you could understand?

8. During this hospital stay, how often were your room and bathroom kept clean?

9. During this hospital stay, how often was the area around your room quiet at night?

10. During this hospital stay, did you need help from nurses or other hospital staff in getting to the bathroom or in using a bedpan?

11. How often did you get help in getting to the bathroom or in using a bedpan as soon as you wanted?

12. During this hospital stay, did you need medicine for pain?

13. During this hospital stay, how often was your pain well controlled?

14. During this hospital stay, how often did the hospital staff do everything they could to help you with your pain?

15. During this hospital stay, were you given any medicine that you had not taken before?

16. Before giving you any new medicine, how often did hospital staff tell you what the medicine was for?

17. Before giving you any new medicine, how often did hospital staff describe possible side effects in a way you could understand?

18. After you left the hospital, did you go directly to your own home, to someone else’s home, or to another health facility?

19. During this hospital stay, did doctors, nurses or other hospital staff talk with you about whether you would have the help you needed when you left the hospital?

20. During this hospital stay, did you get information in writing about what symptoms or health problems to look out for after you left the hospital?

21. Using any number from 0 to 10, where 0 is the worst hospital possible and

22. Would you recommend this hospital to your friends and family?

23. During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding what my health care needs would be when I left.

24. When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.

25. When I left the hospital, I clearly understood the purpose for taking each of my medications.

26. During this hospital stay, were you admitted to this hospital through the Emergency Room?

27. In general, how would you rate your overall health?

28. In general, how would you rate your overall mental or emotional health?

29. What is the highest grade or level of school that you have completed?

30. Are you of Spanish, Hispanic or Latino origin or descent?

31. What is your race? Please choose one or more.

32. What language do you mainly speak at home?

systems-based solutions in acute care

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