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Incredibly Easy blog
The Incredibly Easy blog will expand on selected topics presented in the print journal.
Monday, March 02, 2015

Does your organization have a clearly defined plan for inclement weather or natural disaster? I know by law there must be a written plan, but is it well communicated? Are the members of your organization held accountable for following this plan?

I lived in Florida for more than 25 years and every hospital I was ever associated with made it clear to new hires what was expected of them in times of disaster or inclement weather. Hurricane season has a huge impact on that state, and hospitals and healthcare providers are critical to survival.

I notice a distinct difference when I returned slightly north. Disaster drills and review of disaster plans are common and the required callback rooster is posted. But that sense of duty to the organization isn’t the same. There seems to be a missing sense of importance in responding to the organization when things happen. Staff members are seen as quick to cancel shifts or being no-shows to their required stations. Why do you think this is? What do you believe may be the missing link here?

Is this common in your organization? Could it possibly be that this demand is so infrequent in some areas that organizations are ill prepared and lack a clear understanding of their impact? How does your organization handle emergencies?

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.
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Monday, February 23, 2015

I’ve been keeping an eye on the news in recent weeks as I’m sure most of you have. The winter of 2015 has certainly left its mark all across our country. The particularly cold temperatures have been a health concern. I live in Tennessee and in this “southern” state there have been 21 deaths directly related to the weather in the past week or so. Of these deaths, 18 are linked to hypothermia. I think it’s a good idea to review hypothermia—what it is and who’s at risk.

Hypothermia is a drop in core body temperature. Below 95° F is mild; below 85° F is severe. We understand that exposure to subtherapeutic temperatures is the cause, but who’s at greatest t risk? The elderly and very young are at greatest risk; however, disease processes and health status can also increase the risk of complications due to hypothermia. Diabetes, hypothyroidism, trauma, fluid loss, use of drugs and/or alcohol, body mass index, medications, and immersion can all increase the risk of complications due to exposure. The symptoms range from confusion, slurred speech, cessation of shivering, and fatigue to cardiac slowing and cardiac arrest. The heart and liver produce the bulk of our core body heat and the effects of this loss are felt more acutely by these organ systems.

Stay safe, stay warm, and have a heightened awareness for those individuals at greatest risk.

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.
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Tuesday, February 17, 2015

I believe most nursing professionals understand the concept of patient-centered care in the hospital setting, but how does that model apply in the outpatient setting? Providing care that’s patient centered in this environment requires a nurse case manager. In this role, the professional nurse works with the patient and caregiver(s) to set goals that are collaboratively agreed upon. The case manager assists patients with understanding what’s achievable for their health status and what optimum health is for them. Taking this understanding and working together to set a mutually agreed upon care plan is the essential first step in a patient’s healthcare journey.

As professionals, we’re painfully aware that healthcare today is a complicated interwoven system of insurance demands, program allotments, qualifications, and multidisciplinary requirements. The RN case manager assists the patient and caregiver in navigating this journey and managing barriers in the way of their healthcare goals. Most patients aren’t equipped to do this alone and the case manager becomes their link to success. What’s your experience with nurse case management?

Want more information about patient-centered care? We cover it in our upcoming May/June issue. Stay tuned!

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.
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Monday, February 09, 2015

Measles is a highly contagious and often deadly virus that’s transmitted via the respiratory system or direct contact. The first signs are typically a high fever that begins 10 to 12 days post exposure along with a runny nose, watery eyes, and an outbreak of white spots inside the patient’s mouth. The rash that develops comes a few days later and spreads from the neck and upper body to eventually include the trunk and even the hands and feet. Young children are at the greatest risk for exposure and complications.

Fatalities are most often related to complications, according the World Health Organization (WHO). On its website, the WHO states, “The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhea and related dehydration, ear infections, or severe respiratory infections such as pneumonia.”

I viewed statistics regarding measles and vaccinations. I found that there had been a 75% drop in measles infection from 2000 to 2013 due to vaccination and that there are still an estimated 145,700 deaths annually from measles complications. These deaths are primarily in children under age 5.

Knowing the positive effect that vaccinations have on stopping the spread of this virus, what are your thoughts about vaccinations? In a time when many parents are opting out of vaccinations for their children, we must ask why. Is this fair to the individuals who could potentially be infected? What’s your opinion?

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.
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Monday, February 02, 2015

The National Patient Safety Goals are released by The Joint Commission every year. The goals for 2015 are out and you may notice some recurring themes. The use of two identifiers, for example; patient identification makes the list year after year. The reason it appears annually is that, despite aggressive education and promotion of patient safety, this continues to be at the root of many errors nationally. Why do you suppose that is?

Our policies and procedures all include the use of two identifiers, proper banding, time-out procedures, and patient education on the importance of proper identification. Yet, year after year there are thousands of medical errors associated with improper labeling, improper use of identification, failure to follow time-out procedures, and failure to follow protocols and policy. When you speak with nurses, educators, physicians, and administrators, there seems to be a unanimous consensus that these measures are valuable and essential to patient safety. Failure to follow them properly eventually leads to mistakes, some with severe consequences.

Some experts and administrators blame staffing levels, others blame lack of staff engagement, and some state the processes are flawed. As a nursing professional, why do you believe these essential safety measures aren’t followed?

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.
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About the Author

NursingMadeIncrediblyEasy
The mission of the peer-reviewed journal Nursing made Incredibly Easy! is to meet the ongoing educational needs of nurses in a refreshingly original, easily understood format.