In my most recent editorial for Nursing2014, I addressed the problem of quantity versus quality, and how that’s reflected in our healthcare practice. Patient outcomes and market forces—namely, cost—are driving us to scrutinize past practices and think differently. Though advances in healthcare have saved countless lives and improved quality of life, overuse and misuse has a dark side. Examples include prescribing antibiotics for viral infections at the insistence of the patient or family; the habitual use of radiographic imaging, such as CT scanning, when other modalities may yield suitable information; and performing invasive procedures that may not clearly correlate with improved health outcomes. The related threats are significant: antibiotic resistance and the emergence of “super bugs,” adverse drug reactions, higher cancer rates from diagnostic radiation, and procedural complications. Given the risks, experts are now reconsidering some longstanding guidelines for low-yield screening studies to avoid the risks linked to false-positive or inconclusive results.
What are your thoughts on this issue? Do you agree that more doesn’t necessarily mean better when it comes to healthcare options? Does this affect how you treat your patients? Share your thoughts here!
Friday, September 13, 2013
It's happened to all of us -- a friend wants to know how a patient in your hospital is doing. What do you say?
How do you respond when friends or acquaintances in the community are pressuring you to give them information about a patient in your hospital? Of course, that would be a HIPAA violation. What has been your experience in dealing with these difficult situations?
Monday, July 08, 2013
A recent article about a Kentucky woman who was arrested for impersonating a nurse got me thinking--in the busy rush of everyday practice, would I be able to identify someone in our facility who didn't belong? The nurse in Kentucky walked around the hospital in scrubs -- thankfully she didn't perform any procedures -- for several days. Employees eventually grew suspicious because they didn't recognize her -- but again, it took a few days. Imagine if she had been interacting with and performing procedures on patients! Do you think you could identify someone who didn't belong in your work setting? What procedures does your facility have in place to prevent this from happening? Share your thoughts here!
Wednesday, May 08, 2013
Considering the strong focus on patient safety in clinical practice today, do you feel empowered and supported by your administration to speak up about medical errors and "stop the line" when another clinician or healthcare provider is poised to make a potential medical error? What barriers still exist that must be overcome? What skills or assistance do you need to help you serve as a stronger patient advocate in this situation? I'd love to hear your concerns, advice and lessons learned.