Facts About Home Care Accreditation - Joint Commission: Fill & Download for Free

How to survive your hospitalization.Most people feel that the equation to survive your hospitalization predominantly involves the expertise of your surgeon and the disease at hand.In fact, there is a silent factor that contributes to a phenomenon that is increasingly gaining attention in the medical community, administrative leadership, insurance agencies and popular media: Death related to preventable errors. In To Err is Human, the Institute of Medicine concluded that between 44,000 to 98,000 Americans die each year as a result of medical errors. For comparison, deaths attributable to medical errors exceed those that die from motor vehicle accidents (43,458), breast cancer (42,297) and illicit drug use (17,000).What can you do as a patient?The following are suggestions as a fellow patient and current physician who spends most of my hours thinking of ways to minimize errors:1. The central venous catheter.This is the gateway into your bloodstream to sample blood and deliver medications. These catheters can be life-saving but, in the same breath, they can also be life-threatening. These indwelling catheters can easily deliver a much needed medication to your body, but they can just as easily introduce a bacterial or fungal infection systemically.What you can do:Before your hospitalization, look up your particular hospital: Most hospitals are required by the state to publicly display their Catheter-Associated bloodstream infection rates. Don't be discouraged if your hospital is a "low-performer" when it comes to infection-control: most hospitals are still on a learning curve.Ask your doctor DAILY: "When can this catheter come out?" Be a broken record about it. The DAILY assessment of the need for a central venous catheter is a PROVEN way to minimize your risk.If your hospital is a low-performer, be knowledgeable about the best-way to avoid an infection. Before a healthcare worker accesses your central catheter, they should scrub the entry port at least 15 seconds (not 14 seconds) and let it dry for 15 seconds. Each and every time. Talk to your providers in the beginning and review your expectations and knowledge about this. There are graceful ways of talking about this but at the end of the day, it's your body and your risk should they cut corners in this evidence-based technique. Use your family members to be auditors in this practice.2. Communication is everything.In 2004, the Joint Commission of Accredited Hospitals reviewed all deaths that occurred in a major academic hospital as a result of error. A breakdown in communication was found to be the root cause in more than 70% of the cases.What you can do:Each day, in a notebook, review the following with your physician:How am I doing? (daily assessment)What's my goal for today? (daily plan)The care of the hospitalized patient spans more than one team, one shift, one day. Your care plan gets passed from a morning team, to an afternoon team and to a cross-covering evening team. The next day may introduce new people to your care altogether. By writing down what your primary team sets for you, you share in the authority for continuity in care.Review your care plan with each new staff that takes responsibility for your care. Consulting teams can quickly get on the same page if you are part owner in the care plan. Clear communication across multiple healthcare team members is commonly expected but, as in the Joint Commission's report, should not be assumed.3. No pain, no gain.Expect post-operative pain. Setting this crucial expectation early and upfront is important. The body undergoes major adaptive changes following a big operation. Muscles quickly weaken, hormones shift, appetites suffer and malnourishment exaggerates the insult to the body. Early rehabilitation hurts, but reverses all of these maladaptive processes. Adjust your post-operative pain medications as a means for rehabilitation, not as a means to remain comfortable in bed.What you can do:Rehab early and often. If you are bed-bound, ask for a "Incentive spirometer" and use it every 1 hour while awake. This is exercise-time and crucial to your recovery. If it hurts to take a deep breath, use your pain medications to enable yourself. If you are knocked out, your dose is too high.Ambulate as early as possible. You will likely be miserable at the first attempt, but take courage: it will only get easier and it's good for your lungs. Ambulating (and simply getting out of the laying position) avoids lung collapse which can lead to pneumonia. Better oxygenation helps tissue healing which leads to faster recovery.4. Maintain your sleep-wake cycle.Recovery from surgery often involves recovery from anesthesia. Sedatives used in the post-operative period helps keep you calm but the sleep is not qualitatively restful. You may also find that there will be many obstacles to a normal circadian cycle (vital sign checks every 4 hours, noisy monitors, noisy neighbors, etc).What you can do:As much as possible, keep your blinds open during the day and be exposed to natural light. Try to stay active during the day. Avoid frequent naps during the day lest you fall victim to delirium. At night, cover your windows to block out the night lights.There are not a lot of pharmaceutical sleep aids that are evidence-based. If one works for you, bring your home supply (as hospitals may not stock your particular medication).5. The notebook.Many patients are surprised that they see their physician only once per day - often early in the morning. It's hard to remember all your questions that has formulated throughout the day in a time-pressured setting.What you can do:Write down your questions as they come throughout the day.Enlist the help of your nurse to get your answers. Your nurse will often be your best advocate. A nurse could even take the list of questions you've written down in advance and make sure the medical team covers your basic concerns.It's okay to ask to speak to the physician at any time during the day.Hopefully, having these insights and strategic tools will help you navigate the complicated waters of being a hospitalized patient. Healing is hastened with the mindset that recovery is an active, not a passive process. Additionally, being a pro-active patient will often give you a necessary edge to avoid the mistakes, errors and complications that many hospitals are still trying to figure out.

Only one answer so far had the broad sighted perspective you deserve to hear. I entered nursing school at age 49, after 10 years of existing on SS Disability related to Tourette Syndrome. This was after 2 years of prerequisites at a community college. I finished my academic work at age 53 with a MSN in Family Health and as a Nurse Practitioner. It wasn't a cake walk but it wasn't fire walking on red hot coals either. My RN came after two years in an accelerated BSN program, and I and a classmate (another man) then applied, petitioned about, lobbied for, and finally were admitted directly into the MSN- FNP program of the same school without working as an RN. We were the first at the institution to do so. I knew from the start that hospital shift work was not for me, and felt capable of primary care medicine, and up to the challenge of the material and the practice. We were admitted in keeping with the Joint Commission’s recommendation for a "seamless nursing education to higher degrees of nursing practice.” Even so, I came out of school and had a difficult time finding a job, as did almost every nurse I have ever known, right out of school, regardless of the degree or license. Similar to the requirement for landing a job in any restaurant worth working for in NYC, that one must have NYC restaurant experience regardless of one’s background or arrival date - the same catch 22 exists in NYC for Nursing, with every position requiring 2 years of experience in the discipline having an opening. This is compounded by the fact that no institution grants face to face interviews in their initial selection process - it's all done online and goes by the CV alone. Can you imagine hiring a nurse to join an established staff with only input from a CV that can't tell you a thing about the personality, work ethic or collegial attitude of a candidate? It begs an answer as to what happened, that in a field known for “"Nurses eating their young”, a more considered and personal process was not developed to match the best candidate to an existing nursing culture. Eventually, though, I found two positions, one doing in-home assessments to fulfill the Medicare requirements for insurance companies concerning Preventative and Wellness exams of patients, and the other with an allergy practice, doing patient evaluations and exams; ordering diagnostic tests; developing treatment plans; and administering and evaluating the efficacy and progress of immunotherapy and regimens for asthma and other respiratory conditions associated with allergy.My point is that nursing has many paths to explore, and many destinations where you can find a good fit for your goals, all while taking into consideration, your health problems, your personality, your specific area of interest, etc. , etc. You might consider attending a nursing career fair to explore the variety of nursing positions available, the requirements for each as well as the demand, and the projected trajectory for each discipline in the near and not so near future. You would likely meet many interesting nurses with a wide range of experience and opinions, across the nursing gamut. The field goes far beyond walking the floor on a Med-Surg floor during a grueling 12 hour shift, God Bless the wonderful nurses who rise to that challenge each and every day for the patients recovering on those floors!Finding a good mentor is an indispensable asset to any nurse, nursing student, or someone like yourself, interested in nursing and trying to work out how to go about it. All nurses could benefit from the advice and insights of a nurse with many years of experience across a range of nursing disciplines. Many such nurses are found on the faculties of nursing programs, as an example. There exist positions alternative to a hospital staff position, such as school nurse; corporate nurse attending to the needs of the employees of a firm; community health nurse; research nurse; dialysis and chemo therapy nurse; hospice; etc. In addition, there is the entire field of Nursing Management to consider!If you maintain an open mind and determination of purpose, you can learn something from every nurse you encounter, including, even, what it looks like to have 25 years of experience that have resulted in burnout and a jaded attitude that likely sinks every shift worked. You'll also meet those who were able to find ways to replace that negative attitude with an optimistic outlook that inspires colleagues and patients alike. You might develop two or three direct questions you ask each nurse who you are able to “interview “, about specific aspects of the general nursing experience that are of particular importance to your consideration of the field, and note the respondents’ age, years of experience, type of experience, your impression of his/her personality and, if possible , the impression you get about how the nurse is viewed by colleagues. You will find many and varied types of people who have become nurses, and gain insight regarding the challenges each has faced in adapting to the demands of the various types of nursing practice that exist. This kind of personal research will go a long way toward helping you narrow down the choices available in finding areas of interest you'd like to explore in greater depth when you do independent study projects and clinicals. It could also help you identify specific disciplines that you may regard as something to simply get through coursework and clinical assignments , in order leave behind as merely a requirement fulfilled.Don't give up! If you don't get an answer that satisfies your question , ask the question in a different way, or ask a different person with the authority to give a definitive reply. If you believe in your self and in your capabilities, and demonstrate an enthusiastic determination to succeed, you may find that doors which are closed in most cases often swing open to accommodate the higher needs of those with higher potential to become the nurse leaders of tomorrow. Just be sure you are at all times aware of, and honest with yourself about, your condition and any limitations it might impose upon you, and that you are direct and up front with any and all individuals willing to asssist you in attaining your goals. There are also ways to take your time getting your degree if you need to, with various nursing schools offering a variety of approaches to coursework, including online study in lieu of classroom attendance.Finally, my best advice is to pursue a BSN, directly if possible. You can research online for programs and admittance requirements, and also to verify that, in the end, you will spend as much time attaining an AA degree to sit for the NCLEX as you will a bachelor’s degree. What you may not be told is that your job options are significantly limited with an AARN, as the field is moving toward the BSN as the standard requirement for entry level positions in almost all higher level institutions, and that the Joint Commission demands a very high percentage of the nursing staff be BSN holders in any institution it grants accreditation. Most of these institutions have already adopted the requirement as their standard, and many include the directive that any tenured AARNs on staff meet this requirement, though they are often given generous assistance toward fulfilling the needed coursework, etc. to become BSNRNs.Good luck! Stay strong! Carry a bib and a set of cutlery you can pull out as your response to all career nurses who exhibit any infanticidal tendencies, and be sure to give them the ‘crazy eye’ as you tie the bib around your neck and ask for mayonnaise …..

At the point when Americans are called upon to defend their nation, not so much from remote tyrants or war or fear mongers, but from those individuals who have no intention to commit to their duty, to progress or to democracy or delegate government; who deny any responsibility for anything with the exception of their own wild and unfathomable pits that are their egos, it becomes a very serious matter.The most perilous individual ever selected by a significant gathering for the highest office is sitting in the White House wearing his Oompa Loompa suit, where his base needs scarcely any details and even fewer facts and donald trump is their immoral saviour. Following each offence, our shock and repugnance have been refracted like light through a crystal.You requested a specific list of reasons not to vote for trump. Very well, here it is.Seen all at once, it is horrifying.The Republican Party nominated a man who obnoxiously assaulted the Pope; who assaulted John McCain for being caught by the North Vietnamese; who assaulted Gold Star guardians Khizr and Ghazala Khan and afterwards compared their names with the expression "Radical Islamic Terrorism."He’s the man who assaulted Hillary Clinton, calling her a "bigot." Who labelled her as "brainwashed." As "unhinged." As "a monster." As "the devil." As "the most corrupt candidate ever" showing her face on heaps of hundred-dollar notes and the Star of David. He labelled her as somebody whom "Second Amendment people" ought to take care of. As somebody whose religion "we know nothing about," after he clarified he had never approached God for absolution.He who assaulted President Obama and inferred he was a double-crosser. Who accused him as having been complicit in the Orlando terrorist attack. Who assaulted him for having lower endorsement appraisals than Vladimir Putin, as though Putin's could be trusted; who assaulted him as being born in another nation; who assaulted him as the founder of ISIS, then at that point said it was sarcasm, then said it wasn't sarcasm, then attacked him again as the founder of ISIS.This is a “president” who assaulted the women who accused Roger Ailes of provocation; who assaulted the women who chose abortion and said there ought to be disciplinary actions.The Republican Party nominated a man who assaulted U.S. troops in Iraq and asserted they stole millions; who assaulted Ted Cruz's father claiming he was associated with the death of President Kennedy; assaulted Bill Clinton and claimed he was a rapist. He labelled Mexicans as rapists who brought in drugs and crime; he verbally assaulted African-Americans and asserted they were all living in destitution without any occupations and schools, that they were nothing more than a bad memory; he who assaulted Harrisburg, Pennsylvania, as a "war zone" and assaulted the United States of America and guaranteed it was in a "death spiral."The Republican Party designated for president a man who lied about opposing the war in Iraq, when there is a tape of him condoning it. It was a tape-recorded on the main commemoration of 9/11… trump lied about six million dollars in altruistic gifts to veterans' gatherings from his fundraiser; he lied about bequeathing his benefits from The Celebrity Apprentice, and from "Trump the Game" to St. Jude Cancer Centre. He lied as to why he wouldn't discharge his taxes since he was being audited and substantiated himself a liar by saying he would release his taxes if Hillary Clinton discharged her email messages; he lied about sending his personal jet to ferry stranded U.S. servicemen; he lied about his business in Russia; he lied about meeting Russian president Putin; he lied about "a few people" needing a moment of silence for the killer of five Dallas police officers; he lied about observing a large number of Muslims in New Jersey praising 9/11; he lied about 9/11 criminals sending their wives and lovers home to Saudi Arabia.He lied about a huge number of Syrian exile militants being furtively admitted into the country; and lied about the Chicago police asking him to cancel a rally; he lied about the Chicago police saying they could unravel crime there with "tough police tactics"; he lied about ISIS making millions per week selling Libyan oil; he lied that a nonconformist who attempted to surge onto his stage had "ties to ISIS"; and he lied about refugees entering America carrying mobile phones with "ISIS flags on them" and telephone plans paid ahead of time by ISIS!The Republican Party designated for president a man who praised himself in two tweets and an official statement for anticipating terrorist assaults like Orlando, while bodies still lay in the Pulse dance nightclub. He praised himself after the murder of Dwyane Wade's cousin. He praised himself on foreseeing Brexit, despite the fact that three weeks prior he had never even heard of Brexit.It was he who recommended that Russia or China ought to sanction a Watergate-like hacking of Hillary Clinton's messages; who proposed forbidding Muslims from entering the nation, then at that point said it was just a recommendation, then backflipped again and proposed it once more; who proposed open racial profiling; who proposed restricting individuals from "terror countries," saying, " Look it up, they have a list"; who proposed "ideological accreditation" for foreigners; who proposed more regrettable than waterboarding while at the same time applauding how Saddam Hussein, Vladimir Putin, and Kim Jong-un took care of protests and psychological warfare; who suggested that regular American people be tried by military commissions at Gitmo; who proposed killing the families of psychological militants and suspected terrorists.Here’s a “president” who proposed that schools teach compulsory patriotism; recommended that his supporters designate themselves as political race day voting monitors; proposed evading government debt by printing more money; proposed reducing national obligation by paying short of what was agreed to. He’s a man who planned a wall along the Mexican border to keep out undocumented foreigners; proposed mass expelling of undocumented workers; proposed a smaller divider and fewer deportations during a taped TV interview that played at the same time he was giving a speech in Phoenix demanding a bigger wall and even more expulsions; he suggested promptly removing a few million undocumented migrants, despite the fact that this would resemble attempting to empty the city of Chicago in one day; he proposed ousting any others not indicted but accused of a wrongdoing.All this would be enacted by a man who proposed to order this by bypassing Congress, despite the fact that he employed undocumented migrants in the construction of Trump Tower; despite the fact that those outsiders state not only did he know about them but he personally procured them; despite the fact that his modelling agency and TV programs enabled undocumented settlers; despite the fact that his wife may have worked here without legitimate documentation; despite the fact that his own grandfather was purportedly not just a deceitful displaced person to this nation but was denied re-entry to Germany since he was a draft-dodger.This is a man who guaranteed he comprehended prejudice against African-Americans in light of the fact that the framework is likewise rigged against him; who claimed the political race will be fixed against him; who asserted the opinion polls are fixed against him, at that point lauded one of precisely the same surveys when it favoured him; who has asserted he was his own best international strategy consultant; guaranteed that Putin won't go into Ukraine when he previously attacked Ukraine in 2014; asserted the U.S. is paying rent for an army installation in Saudi Arabia when the last one there shut in 2003.Here’s a “president” who claims that any competitor using a teleprompter ought to be ineligible, and afterwards started using one; he declared that he doesn't use notes for speeches during a discourse he gave that came essentially from notes; he declared he will fix the issues of African-Americans, then days after the fact, proposed that an African-American athlete objecting to police shootings should leave America.The Republican Party has really done a job selecting a man who was discovered to have asked his international strategy counsellors multiple times in a single hour why America cannot utilise atomic weapons since she has atomic weapons in the wake of having asked a TV interviewer a similar inquiry; who was seen to have not comprehended what the "nuclear triad” (set of three) was.Here’s a hypocrite who was exposed to have been the political recipient of fake Internet accounts guaranteed by the Kremlin; discovered to have inappropriately sought crusade commitments from remote nationals, including authorities of remote governments; a man who was revealed to have deleted all his email messages, incorporating those looked for in a lawsuit for five years; uncovered to have plagiarized up to 20 pages in his Trump Institute handbook; revealed to have hired the author of his wife’s Convention speech which appropriated some portion of a speech composed for Michelle Obama by Hillary Clinton's previous speech specialist; and who has aligned himself with his own son, who follows a progression of racial oppressor Twitter accounts.The Republican Party has assigned for “president”, a man who tweeted thanks to Billy Joel for dedicating a song to him, never acknowledging who Joel was, thus, by doing so, deriding him; he who gave a trade speech in Monessen, Pennsylvania, stood before a wall made out of bundles of compacted rubbish; who boasted during a presidential discussion about the size of his genitalia; who gave a TV interview while situated before a photo of himself wearing an all too similar suit, shirt, and tie (Oompa Loompa); who showed up in a joint news gathering with the leader of Mexico, with two bobby pins so obvious, they were holding his hairdo in place because he’d run out of hairspray.If it wasn’t so serious it would be laughable.The Republican Party has really paid homage to America. Choosing for president an untrustworthy, naïve, whimsical, malignant bigot. An Islamophobic, fascistic, vindictive, barbaric individual named donald john trump.Crazy. Just utter madness.