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Assessing the Impact of an Electronic Medical Record on Nurse
CIN: Computers, Informatics, Nursing & Vol. 26, No. 4, 234–241 & Copyright B 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins FEATURE ARTICLE Assessing the Work sampling measured nurse documentation Impact of an time before and after the implementation of an electronic medical record on a medical-surgical Electronic Medical nursing unit. Documentation was separated into subprocesses of admissions, discharges, and Record on Nurse routine/daily documentations. Production rate of documentation time is defined and measured. The results indicate that there is no difference in Documentation Time documentation time between pre-electronic med- ical record and post-electronic medical record for BRIAN HAKES, MBA admissions and routine/daily documentation time. JOHN WHITTINGTON, MD Post-electronic medical record documentation time was longer than that in the pre-electronic medical record for patients discharged to a nursing home. It was demonstrated that the electronic medical record may reduce documentation time after the Healthcare today is facing constant pressure to decrease adoption of computerized physician order entry. waste and reduce cost. Improving efficiency, safety, and quality is the reason for implementing an electronic KEY WORDS medical record (EMR). However, studies have shown EMR Benefit Realization & variable impact.1–7 At OSF HealthCare System in Peoria, Information System Benefit Realization & IL, the EMR vendor, IDX Corporation (GE Healthcare, Nurse Documentation Time & 8 Seattle, WA), issued a press release stating that on Nurse Efficiency and Documentation & average, a nurse using a paper-based documentation Nurse Utilization & system spends about 30% of his/her time—more than 3 Work Sampling of Nurse Documentation Time hours out of each 12-hour shift—on documentation. -
Serous Papillary Adenocarcinoma of Unknown Primary in a Recurrent Paravaginal Cyst
Hindawi Case Reports in Obstetrics and Gynecology Volume 2019, Article ID 8125129, 4 pages https://doi.org/10.1155/2019/8125129 Case Report Serous Papillary Adenocarcinoma of Unknown Primary in a Recurrent Paravaginal Cyst Khilen Patel , Advaita Punjala-Patel, Angela Stephens, and John Lue Department of Obstetrics and Gynecology, Augusta University, Medical College of Georgia, 1120 15th St., Augusta, GA 30912, USA Correspondence should be addressed to Khilen Patel; [email protected] Received 14 February 2019; Revised 1 May 2019; Accepted 28 May 2019; Published 10 June 2019 Academic Editor: Giampiero Capobianco Copyright © 2019 Khilen Patel et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Cystic lesions located in the paravaginal region are rare. When present, paravaginal cysts are typically benign and are incidentally found on routine gynecological exams; however, rarely they can be malignant. Treatment options for paravaginal cancers are not well studied and early diagnosis may help improve prognosis in these patients. Our case describes a 55-year-old female with a recurrent paravaginal cyst that was remarkable for serous papillary adenocarcinoma despite biopsy and fuid cytology negative for malignancy. Tis case demonstrates that malignancy should be considered highly with a recurrent paravaginal cyst, especially when present over a short interval. 1. Introduction due to postmenopausal symptoms and denied any vaginal bleeding or vaginal discharge. On bimanual examination, the Large paravaginal cysts are rare and when present are most uterus and cervix were noted to be surgically absent; however, commonlybenign.Tesecystscanbeeithercongenitalor alargepelvicmasswaspalpated.Tismasswassmooth, acquired. -
Board Review from ACP MEDICINE
BOARD REVIEW FROM MEDSCAPE Case-Based InternalInternal Medicine Self-Assessment Questions CLINICAL ESSENTIALS CARDIOVASCULAR MEDICINE DERMATOLOGY ENDOCRINOLOGY GASTROENTEROLOGY HEMATOLOGY IMMUNOLOGY/ALLERGY INFECTIOUS DISEASE INTERDISCIPLINARY MEDICINE METABOLISM NEPHROLOGY NEUROLOGY ONCOLOGY PSYCHIATRY RESPIRATORY MEDICINE RHEUMATOLOGY www.acpmedicine.com BOARD REVIEW FROM MEDSCAPE Case-Based Internal Medicine Self-Assessment Questions Director of Publishing Cynthia M. Chevins Director, Electronic Publishing Liz Pope Managing Editor Erin Michael Kelly Development Editors Nancy Terry, John Heinegg Senior Copy Editor John J. Anello Copy Editor David Terry Art and Design Editor Elizabeth Klarfeld Electronic Composition Diane Joiner, Jennifer Smith Manufacturing Producer Derek Nash © 2005 WebMD Inc. All rights reserved. No part of this book may be reproduced in any form by any means, including photocopying, or translated, trans- mitted, framed, or stored in a retrieval system other than for personal use without the written permission of the publisher. Printed in the United States of America ISBN: 0-9748327-7-4 Published by WebMD Inc. Board Review from Medscape WebMD Professional Publishing 111 Eighth Avenue Suite 700, 7th Floor New York, NY 10011 1-800-545-0554 1-203-790-2087 1-203-790-2066 [email protected] The authors, editors, and publisher have conscientiously and carefully tried to ensure that recommended measures and drug dosages in these pages are accurate and conform to the standards that prevailed at the time of publication. The reader is advised, however, to check the product information sheet accompanying each drug to be familiar with any changes in the dosage schedule or in the contra- indications. This advice should be taken with particular seriousness if the agent to be administered is a new one or one that is infre- quently used. -
Management of Locally Advanced Rectal Adenocarcinoma Oncology Board Review Manual
ONCOLOGY BOARD REVIEW MANUAL STATEMENT OF EDITORIAL PURPOSE Management of Locally The Hospital Physician Oncology Board Review Advanced Rectal Manual is a study guide for fellows and practicing physicians preparing for board examinations in oncology. Each manual reviews a topic essential Adenocarcinoma to the current practice of oncology. PUBLISHING STAFF Contributors: Nishi Kothari, MD PRESIDENT, GROUP PUBLISHER Assistant Member, Department of Gastrointestinal Bruce M. White Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL SENIOR EDITOR Khaldoun Almhanna, MD, MPH Robert Litchkofski Associate Member, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research EXECUTIVE VICE PRESIDENT Institute, Tampa, FL Barbara T. White EXECUTIVE DIRECTOR OF OPERATIONS Jean M. Gaul Table of Contents Introduction .............................1 Clinical Evaluation and Staging ..............2 Management .............................4 NOTE FROM THE PUBLISHER: This publication has been developed with Surveillance and Long-Term Effects ..........8 out involvement of or review by the Amer ican Board of Internal Medicine. Conclusion ..............................9 Board Review Questions ...................10 References .............................10 Hospital Physician Board Review Manual www.turner-white.com Management of Locally Advanced Rectal Adenocarcinoma ONCOLOGY BOARD REVIEW MANUAL Management of Locally Advanced Rectal Adenocarcinoma Nishi Kothari, MD, and Khaldoun Almhanna, MD, MPH INTRODUCTION ence to -
Nursing Historical Highlights F RON T COV E R
NURSING HISTORICAL HIGHLIGHTS F RON T COV E R : Forever Caring, dedicated October 7, 2003 Gift of Mayo Clinic in recognition of nursing colleagues and the philanthropic leadership of Marilyn J. (Methodist Kahler School of Nursing Graduate) and Warren F. Bateman. Artist Gloria Tew has expressed the primary value of Mayo Clinic - “the needs of the patient come first” - in the concept of this bronze tableau. Figures of nurses are arranged to portray the retrospective histories of Saint Marys Hospital, founded by the Sisters of Saint Francis, and the Rochester Methodist Hospital. Contemporary figures of a female and male nurse show the response of the nursing profession to current and future patient care needs. Nurses in advanced practice, education and research, the threefold mission of Mayo Clinic, are shown in the nurse anesthetist, the graduate nurse, and the nurse with a patient’s chart. The tableau also honors the former schools of nursing in Rochester by depicting their distinctive caps: Saint Marys School of Nursing (nurse with patient chart); Methodist Kahler School of Nursing (nurse with patient in a wheelchair), and Saint Marys School of Practical Nursing (nurse with serving tray). The following timeline offers insight into the rich history of nursing at Mayo Clinic in Rochester. From Mayo’s beginning, nursing has been a significant part of our education, practice, and research. Nursing at Mayo has mirrored the growth of the Mayo Clinic and the campuses of Mayo Clinic Hospital. While this timeline depicts nursing highlights, each of these points in time has a full history of its own. -
APPLICATION of the PATIENT CHECKLIST TOOL in ANESTHESIA HANDOFFS Theresa Durley Northern Michigan University, [email protected]
Northern Michigan University NMU Commons DNP Scholarly Projects Student Works 4-2017 APPLICATION OF THE PATIENT CHECKLIST TOOL IN ANESTHESIA HANDOFFS Theresa Durley Northern Michigan University, [email protected] Follow this and additional works at: http://commons.nmu.edu/dnp Part of the Perioperative, Operating Room and Surgical Nursing Commons Recommended Citation Durley, Theresa, "APPLICATION OF THE PATIENT CHECKLIST TOOL IN ANESTHESIA HANDOFFS" (2017). DNP Scholarly Projects. 2. http://commons.nmu.edu/dnp/2 This Scholarly Project is brought to you for free and open access by the Student Works at NMU Commons. It has been accepted for inclusion in DNP Scholarly Projects by an authorized administrator of NMU Commons. For more information, please contact [email protected],[email protected]. APPLICATION OF THE PATIENT CHECKLIST TOOL IN ANESTHESIA HANDOFFS By Theresa Marie Durley SCHOLARLY PROJECT Submitted to Northern Michigan University In partial fulfillment of the requirements For the degree of DOCTOR OF NURSING PRACTICE School of Nursing May 2017 SIGNATURE APPROVAL FORM APPLICATION OF THE PATIENT CHECKLIST TOOL IN ANESTHESIA HANDOFFS This DNP Scholarly Project by Theresa Marie Durley is recommended for approval by the student’s Faculty Chair, Committee and Department Head in the School of Nursing Dr. Katie Menard 4/13/17 Committee Chair: Date Dr. Melissa Romero 4/13/17 First Reader: Date Dr. Jane Campbell 4/13/17 Second Reader (optional): Date Dr. Nanci Gasiewicz 4/13/17 Department Head: Date ABSTRACT APPLICATION OF THE PATIENT CHECKLIST TOOL IN ANESTHESIA HANDOFFS By Theresa Marie Durley Accurate and essential communication is required during the transfer of patient care from one health care provider to another. -
Improving Nurse Anesthetist Intraoperative Handoff Process by Developing and Implementing an Evidence-Based, Facility-Specific Cognitive Aid
Journal of Nursing & Interprofessional Leadership in Quality & Safety Volume 2 Issue 2 Article 1 May 2019 Improving Nurse Anesthetist Intraoperative Handoff Process by Developing and Implementing an Evidence-Based, Facility-Specific Cognitive Aid Jason Silva The University of Texas MD Anderson Cancer Center, [email protected] Myron Arnaud The University of Texas Health Science Center at Houston, [email protected] Follow this and additional works at: https://digitalcommons.library.tmc.edu/uthoustonjqualsafe Part of the Anesthesiology Commons, Health and Medical Administration Commons, Health Communication Commons, Nursing Administration Commons, and the Perioperative, Operating Room and Surgical Nursing Commons Recommended Citation Silva, J., & Arnaud, M. (2019). Improving Nurse Anesthetist Intraoperative Handoff Process by Developing and Implementing an Evidence-Based, Facility-Specific Cognitive Aid. Journal of Nursing & Interprofessional Leadership in Quality & Safety, 2 (2). Retrieved from https://digitalcommons.library.tmc.edu/uthoustonjqualsafe/vol2/iss2/1 This article is free and open access to the full extent allowed by the CC BY NC-ND license governing this journal's content. For more details on permitted use, please see About This Journal. Improving Nurse Anesthetist Intraoperative Handoff Process by Developing and Implementing an Evidence-Based, Facility-Specific Cognitive Aid Abstract Miscommunication or non-transfer of pertinent patient information during intraoperative handoffs between anesthesia providers creates patient safety risks. An evidence-based facility-specific cognitive aid was developed and introduced to nurse anesthetists in an anesthesiology department of a large academic hospital with the aim of improving the intraoperative patient handoff process. The program used a handoff cognitive aid that addressed five pertinent patient information points. -
Grading Evidence
Grading Evidence Analysis of the colonoscopic findings in patients with rectal bleeding according to the pattern of their presenting symptoms Journal Diseases of the Colon & Rectum Publisher Springer New York ISSN 0012-3706 (Print) 1530-0358 (Online) Issue Volume 34, Number 5 / May, 1991 Abstract Patients presenting with rectal bleeding were prospectively categorized according to the pattern of their presentation into those with outlet bleeding (n=115), suspicious bleeding (n=59), hemorrhage (n=27), and occult bleeding (n=68). All patients underwent colonoscopy and this was complete in 94 percent. There were 34 patients with carcinoma and 69 with adenomas >1 cm diameter. The percentage of neoplasms proximal to the splenic flexure was 1 percent in outlet bleeding, 24 percent with suspicious bleeding, 75 percent with hemorrhage, and 73 percent with occult bleeding. Barium enema was available in 78 patients and was falsely positive for neoplasms in 21 percent and falsely negative in 45 percent. Colonoscopy is the investigation of choice in patients with suspicious, occult, or severe rectal bleeding. Bleeding of a typical outlet pattern may be investigated by flexible sigmoidoscopy. J Surg Res. 1993 Feb;54(2):136-9. Colonoscopy for intermittent rectal bleeding: impact on patient management. Graham DJ, Pritchard TJ, Bloom AD. Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106. Abstract Rectal bleeding is a frequent presenting symptom of a number of benign anorectal disorders. However, it may also be a warning sign of more significant gastrointestinal pathology. For this reason, full colonic evaluation has been recommended in patients with intermittent bright red rectal bleeding. -
New Technology in Nursing Education and Practice
IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 6, Issue 6 Ver. I. (Nov. Dec .2017), PP 29-38 www.iosrjournals.org New Technology in Nursing Education and Practice Ragaa Gasim Ahmed Mohmmed1, Hanan Mohammed Mohammed2,4, Abeer El-Said Hassane El-sol3,4 1 (Assistant professor of Pediatric Nursing, Faculty of Applied Medical Sciences, Nursing Department, Al-Baha University, Saudi – Arabia) 2 (Assistant Professor of Medical-Surgical Nursing Department, Faculty of Nursing, Ain Shams University, Egypt) 3 (Lecturer of Medical-Surgical Nursing, Medical Surgical Department, Faculty of Nursing, Shibin Elkom, Menoufia University, Egypt) 4 (Faculty of Applied Medical Sciences, Nursing Department, Al-Baha University, Saudi – Arabia) Ragaa Gasim Ahmed Mohmmed Corresponding Author: [email protected] Abstract: Technology is changing the world at warp speed and nowhere is this clearer than in health care settings. In an increasingly crowded world, people rightly expect health care to meet their needs quickly and, where possible, tailored to their needs. Technology helps to deliver these elements, putting the power back in the hands of the patient. Health care is growing increasingly complex, and most clinical research focuses on new approaches to diagnosis and treatment. In contrast, relatively little effort has been targeted at the perfection of operational systems, which are partly responsible for the well-documented problems with medical safety. If medicine is to achieve major gains in quality, it must be transformed, and information technology will play a key part, especially with respect to safety. Technological innovation in health care is an important driver of cost growth. -
Medical-Surgical Nursing Test Content Outline
Test Content Outline Effective Date: October 25, 2014 Medical-Surgical Nursing Board Certification Examination There are 175 questions on this examination. Of these, 150 are scored questions and 25 are pretest questions that are not scored. Pretest questions are used to determine how well these questions will perform before they are used on the scored portion of the examination. The pretest questions cannot be distinguished from those that will be scored, so it is important for a candidate to answer all questions. A candidate's score, however, is based solely on the 150 scored questions. Performance on pretest questions does not affect a candidate's score. This Test Content Outline identifies the areas that are included on the examination. The percentage and number of questions in each of the major categories of the scored portion of the examination are also shown. Category Domains of Practice No. of Questions Percent I Assessment and Diagnosis 22 14.67% II Planning, Implementation and 50 33.33% Outcomes Evaluation III Professional Role 45 30.00% IV Health Teaching and Health 33 22.00% Promotion Total 150 100% Test Content Outline American Nurses Credentialing Center Effective Date: October 25, 2014 Medical-Surgical Nursing I Assessment and Diagnosis (14.67%) A. Gather Comprehensive Patient Data Knowledge of: 1. Components of a health history and psychosocial assessment 2. Sources and procedures for obtaining diagnostic studies and test results 3. Normal structure and function (e.g., anatomy, physiology) across the life span Skills in: 4. Collecting data from multiple sources using therapeutic interviews and observations (e.g., prescribed and non-prescribed medications, allergies, immunizations, psychosocial factors, nutrition, alcohol and drug use, suicide screening, abuse and neglect, environment, complementary and alternative therapies) 5. -
Technology Target Studies: Technology Solutions to Make Patient Care Safer and More Efficient
Technology Target Studies: Technology Solutions to Make Patient Care Safer and More Efficient AMERICAN ACADEMY OF NURSING WORKFORCE COMMISSION MONOGRAPH Author Carole Gassert, PhD, RN, FACMI, FAAN Workforce Commission Membership Pamela F. Cipriano, PhD, RN, FAAN - Chair Pamela Mitchell, PhD, RN, FAHA, FAAN - AAN Board Liaison Ida Androwich, PhD, RNC, FAAN Linda Burnes Bolton, DrPH, RN, FAAN Marilyn P. Chow, DNSc, RN, FAAN Brenda Cleary, PhD, RN, FAAN Carole A. Gassert, PhD, RN, FACMI, FAAN Lillee Gelinas, MSN, RN, FAAN Denise H. Geolot, PhD, RN, FAAN Susan Hassmiller, PhD, RN, FAAN Diane J. Mancino, EdD, RN, CAE Margaret L. McClure, EdD, RN, FAAN Patricia Moritz, PhD, RN, FAAN Pamela Austin Thompson, MS, RN, FAAN The Technology Targets work was generously funded by the Robert Wood Johnson Foundation. © 2009 American Academy of Nursing Workforce Commission Table of Contents I. Executive Summary ................................................................................................ 3 II. Introduction to the Problem .................................................................................. 6 III. Phase I, Invitational Conference: .......................................................................... 7 Using Innovative Technology to Enhance Patient Care Delivery .................................................... 7 IV. Phase II, Pilot Study: .......................................................................................... 11 Creating a Technology Enhanced Practice Environment in Acute Care Hospitals ................. -
CASE FILES® Family Medicine
SECOND EDITION CASE FILES® Family Medicine Eugene C. Toy, MD The John S. Dunn, Senior Academic Chair and Program Director The Methodist Hospital Obstetrics and Gynecology Residency Program Houston, Texas Vice Chair of Academic Affairs Department of Obstetrics and Gynecology The Methodist Hospital–Houston Associate Clinical Professor and Clerkship Director Department of Obstetrics and Gynecology University of Texas Medical School at Houston Houston, Texas Donald Briscoe, MD Director, Family Medicine Residency Program and Chair, Department of Family Medicine The Methodist Hospital—Houston Medical Director Houston Community Health Centers, Inc. Houston, Texas Bruce Britton, MD Clinical Associate Professor and Family Medicine Clerkship Director Department of Family and Community Medicine Eastern Virginia Medical School Portsmouth, Virginia Bal Reddy, MD Director of Predoctoral Education Assistant Professor Department of Family Medicine University of Texas Medical School at Houston Houston, Texas New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2010 by The McGraw-Hill Companies, Inc. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. ISBN: 978-0-07-160024-8 MHID: 0-07-160024-8 The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-160023-1, MHID: 0-07-160023-X. All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occur- rence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark.