Tuesday, March 23, 2010

Hello,

My preceptor and I have been discussing the change project. I'm precepting in an endoscopy center so it was kind of difficult to come up with something. The major problem in endoscopy is infection control. It has been in the news for the past 4-6 months now. The VA hospital in Miami found that the scopes were not being properly cleaned and patients have been allegedly infected with Hep C, HIV, amongs other infections. A privately owned clinic in Las Vegas found that an Anesthesiologist was reusing syringes even though he changes out the needles were infecting patients with Hep C. As i continue read on the affects of infection control in outpatient setting I have decided to do what my preceptor and I called surveillance screening on nursing home patients.

Nursing home patients have procedures in outpatients faclilities and their only historians are their nursing aides. Althought they may have been working with that patient they don't know all the information we need in order to properly care for the patient. I have noticed that the nursing home patients come to the center with wounds that we were not informed about in the pre-op assessment. They have hx of MRSA,VRE, Hep C, Swine flu,C-diff amongst other infections that are not revealed.

My plan is to do surveillance screening on recent infections of nursing home patients prior to procedures.This is for the safety of the staff and to decrease the chances of the patient passing the infection on to staff and other families waiting for their procedures. The outcome of this is to wean out these patients and to ultimately be able to implement this into policy. These patients would not be able to have procedures done in an outpatient setting. The reasoning behind this is because outpatient facilities are not always able to follow these patients and they may not have a procedure done in this particular facility again.

Monday, March 8, 2010

Nsg Journal Blog

This post is actually for last week. The place where I chose to do my preceptorship is actually a little different from most of yours. I go to an endoscopy center. My preceptor is very autonomous. Her meetings usually consist of emails and phone conferences. She has quarterly staff meetings to keep up to date on what's going on in the facility and the endocopy world. Today, I witnessed her doing payroll, submit invoices to corporate so they can approve the bills that she has to pay. She had short meetings with vendors to discuss contracts for supplies they use for the center. There was a patient complaint regarding the copay that the patient was required to pay and she didn't have the money. My preceptor had to get approval from the doctor and was willing to make payment arrangements so the patient can have her procedure done. In today's healthcare I think a majority of patients would have been cancelled and/or rescheduled to come back when they had the money together. My preceptor has her BSN and a MBA, she states, "with my MBA I'm not limited to bedside care. " This makes since because bedside care can cause burnout to some and this cushion can give you peace of mind.