PurposeThis week's graded discussion topic relates to the

PurposeThis week’s graded discussion topic relates to the following Course Outcome (CO). CO 5: Apply improvement methods, based on data from the outcomes of care processes, to design and test changes to continuously improve the quality and safety of healthcare. (PO 8)The AssignmentReview the story at the link below before posting to the discussion:Rau, J. (2015). Half of nation’s hospitals fail again to escape Medicare’s readmission penalties. Kaiser Health News. Retrieved from http://khn.org/news/half-of-nations-hospitals-fail-again-to-escape-medicares-readmission-penalties/ (Links to an external site.)Links to an external site.After you have finished, consider how you would respond to the following situation:Your local hospital has received notice from CMS (Centers for Medicare and Medicaid) regarding their readmission rates. As a BSN prepared nurse, you have been asked to serve as a consultant to suggest a new Quality (Performance) Improvement process for ONE of the areas of deficiency. Write some brief steps (suggestions) for improvement as you contemplate accepting the consulting opportunity. Share practice improvements utilized from your own clinical nursing experiences that have led to enhanced patient outcomes.Patient outcomes are a direct result of quality care. What would be your primer for one area of improvement that data has presented as an opportunity? What national benchmark are you comparing your benchmark to? ExampleI have been asked, as a BSN prepared nurse to evaluate and promote a quality performance improvement plan process for patient readmissions involving those patients with congestive heart failure, CHF (Rau, 2015). The first step is to review the pharmacy medication reconciliation to ensure the medications prescribed reflect the core measures for the type of CHF the patient has. Patients with systolic dysfunction with an ejection fraction less than 40%, require an angiotensin receptor blocker. Other targeted measures require some patients to take a beta blocker (American Heart Association, 2013). The diagnosis of hypertension needs to be addressed. If present, an ACEI or ARB, beta blocker, and hydralize should be on the medication list. In addition to cardiac medications,  an evaluation of diuretics such as Lasix needs to be evaluated with consideration of the dose and if a dose increase is warranted. The second step requires a recent echocardiogram within the last six months to be on the record, if there is not, then one needs to be done during the concurrent hospitalization. During the hospitalization, DVT prophylaxis needs to be given, as many patients with CHF are non-ambulatory (American Heart Association, 2013).The reason for hospital readmission needs to be evaluated, such as an acute on chronic episode of systolic, diastolic or combined systolic and diastolic heart failure needs to be known. Has the patient been compliant with mediation, sodium intake, and daily weight?  Follow-up physician appointments with a reminder and resources available for the patient to get to and from appointments are other considerations. The last item to review is those patients requiring a CPAP at night or oxygen. Does the patient have a working machine and enough oxygen on hand? These are all items that can be tracked in order to prevent readmission in less than 30 days. Upon discharge, information on the heart failure clinic needs to be reviewed with both the patient and family member. The heart failure clinic has additional resources available such as a customized management plan for home, a calendar to record daily weight and symptoms, bathroom scale, sodium tracker, and if needed a pill organizer.Clinical experience that can be drawn from my current nursing role as a clinical documentation specialist, CDS includes the identification of a specific diagnosis. An abundant number of patients are admitted with CHF, but further clarification is required if the physician simply documents the reason for admission is CHF. The acuity comes first. The difference between acute and chronic or acute on chronic is mediation, lab values, and patient presentation. Symptoms such as a BNP over 100, increased shortness of breath, increased edema, lung sounds with crackles, orthopnea and an increase in diuretic dosage especially if the change is from oral to intravenous requires clarification if the patients are having an acute exacerbation. Next includes the identification of the type of heart failure such as systolic or diastolic CHF. Systolic heart failure includes patients with a reduced EF, while diastolic CHF are those with a preserved EF and diastolic dysfunction. There are also patients that have both diastolic dysfunction and a reduced EF. Identification of the type of heart failure is paramount, as treatment and medication choices can differ. ReferencesAmerican Heart Association. (2013). Get with the guidelines heart failure. Retrieved from http://www.heart.org/idc/groups/heart-public/@private/@wcm/@hcm/@gwtg/documents/downloadable/ucm_310967.pdf (Links to an external site.)Links to an external site.Finkelman, A. (2016). Leadership and management for nurses: Core Competencies for quality care (3rd ed.). Boston, MA: Pearson.Licking Memorial Health. (2018). LMH heart failure clinic services. Retrieved from https://www.lmhealth.org/Services-Facilities/Hospital-Services/Heart-Care (Links to an external site.)Links to an external site.Rau, J. (2015). Half of nation’s hospitals fail again to escape Medicare’s readmission penalties. Kaiser Health News. Retrieved from https://khn.org/news/half-of-nations-hospitals-fail-again-to-escape-medicares-readmission-penalties/ (Links to an external site.)Links to an external site.

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Ask A Question and we will direct you to our Order Page at WriteDemy. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.

Do you need an answer to this or any other questions?

We are here to help you

Answers

Related Questions

Science : Answer Double Blind Control Experiment...

What is a Double-blind control experiment?Definition and ExplanationA double blind control experiment is an experimental procedure that eliminates bia...

Business Law : The Correct Property Law Paper...

Running head: PROPERTY LAW1Property lawName of studentProfessors nameCourse titleDate2PROPERTY LAWA comparative essay of English law, Islamic law and...

Business Law : White Collar Crime 1...

Surname 1White-Collar CrimeStudent name:Instructors name:Date:Discuss the key elements of identifying white-collar crimes. Next, determine at least tw...

Psychology : 694046...

Running head: ADOLESCENCE AND EMERGING ADULTHOODAdolescence and Emerging AdulthoodStudents NameInstitution Affiliation2ADOLESCENCE AND EMERGING ADULTH...

Art & Design : Art Gallery Powerpoint...

Classical Mythology in Renaissance Art10/17/2017Classical Mythology in Renaissance ArtI chose Classical Mythology in Renaissance Art due tothe fact I...

Calculus : Adding And Subtracting...

Adding and SubtractingFunctionsf(x) = x2 + 3xg(x) = 8x + q(f+g)(x) = f(x) + g(x)(x2 + 3x) + (8x+q)= x2 + 11x + q(f-g)(x) = f(x) g(x)= (x2 + 3x) - (8x+...

Mathematics : Q1...

Q. A student was asked to divide a number by 6 and add 12 to the quotient. He, however firstadded 12 to the number and then divided it by 6, getting 1...

Accounting : 1 Interest Rat...

(1) Interest rate is not the sole determinant of car sales. The other factors to consider are:(a) Consumer income.Even at low interest rates, car sale...

English : Doctors Needed In State Of Florida Adver...

Doctors needed in State of FloridaVacancy! Vacancy! Vacancy!Following the havoc caused by the ongoing hurricane, the Hospital of Florida would like to...

Environmental Science : Cirrus Clouds...

Cirrus cloudsCirrus clouds are high-level clouds that appear in the form of white narrow and delicatefilaments. Their shape varies from hair-like, fin...

Management : Pad 505 Public Budgeting And Finance...

Running head: GOVERNMENT1PAD 505: Public Budgeting and Finance - Flu Vaccination ProgramStudent NameUniversity AffiliationGOVERNMENT2The local governm...

Management : Employee Customer Service 1...

Running Head: EMPOYEE CUSTOMER SERVICEEmployee Customer ServiceStudents NameLecturers NameCourse TitleDate1EMPLOYEE CUSTOMER SERVICE2Employee Customer...

Psychology : P480 Leadership Efforts.edited...

Running head: LEADERSHIP EFFORTS1Leadership effortsInstitution AffiliationDateLEADERSHIP EFFORTS2Every organization is required to have a learning cul...

Philosophy : G252 The Church.edited...

Running head: THE CHURCH1The ChurchInstitution AffiliationDateTHE CHURCH2The church is currently a major association in the society that encourages se...

Psychology : Psy 832 Week 3 Dq 1...

Running head: EDGAR SCHEINS MODEL OF ORGANIZATIONAL CULTUREEdgar Scheins Model of Organizational CultureStudents NameProfessors NameInstitution Affili...

Article Writing : Freedom Writers...

Running head: FREEDOM WRITER1FREEDOM WRITERAuthors name:Institution affiliation:FREEDOM WRITER2FREEDOM WRITERThe movie, Freedom Writers, is based on a...

English : Holocaust Victims Final 1...

Running Head: HOLOCAUST VICTIMS1Holocaust VictimsNAME OF STUDENTINSTITUTIONPROFESSORS NAMEDATE2HOLOCAUST VICTIMSHolocaust VictimsIntroductionFrom 1939...

Marketing : Situation Analysi1...

Running head: SITUATION ANALYSIS1Situation AnalysisNameInstitutionInstructorCourseDateSITUATION ANALYSIS2Situation AnalysisTarget markets: provide inf...

Health & Medical : Heart Diseasecomp...

Running head: CHRONIC DISEASE1Coronary Heart DiseaseNameInstructorCourseDateCHRONIC DISEASE2This is a condition where a plaque forms in the coronary a...

Business : Member Solutions Representative...

Running head: FLOWCHART IMPROVEMENT PROCESSFlowchart Improvement ProcessName:Institution:Instructor:Course:Date:1FLOWCHART IMPROVEMENT PROCESS2Introdu...

Psychology : Cognitive Dissonance...

Running head: COGNITIVE DISSONANCE1Cognitive DissonanceNameInstitutionInstructorCourseDateCOGNITIVE DISSONANCE2Cognitive DissonanceCognitive dissonanc...

History : Impacts Of Vietnam War.edited...

Running head: CONSEQUENCES OF VIETNAM WARConsequences of Vietnam WarStudent Name:Institution:Date:1CONSEQUENCES OF VIETNAM WAR2Consequences of Vietnam...

Biology : Lab Assignment...

Lab 5 Tissues and SkinBIO201LStudent Name: Click here to enter text.Kit Code (located on the lid of your lab kit):Click here to enter text.Pre-Lab Que...

Business : Should Sustainability Have A Seat In Th...

Running head: SHOULD SUSTAINABILITY HAVE A SEAT IN THE C-SUITEShould Sustainability Have a Seat in the C-SuiteName:Institutional affiliation1SHOULD SU...

If you didn't find the right answer

Ask Your Questions, We'll notify you once someone answers it