Bold Voices - April 2014 - (Page 9)

AT THE BEDSIDE One out of four ED patients is elderly. At least 150 hospitals are developing senior-specific emergency departments. I n response to an increasing senior population and the fact that seniors account for up to 25 percent of all emergency department (ED) visits worldwide, more than 50 U.S. hospitals have built senior-specific EDs since 2011, and at least 150 others have them in development, a recent article states. According to "Growth of SeniorSpecific EDs Holds Quality Promise but Raises Cost Issues," in Modern Healthcare, some critics question whether these EDs improve patient outcomes. The investment - which can range from $150,000 to $3.2 million - does not have an immediate financial payback. Since reimbursement is not contingent upon a specific type of ED, patient outcomes will determine whether the move is profitable, especially since the Affordable Care Act financially penalizes hospitals for having higher readmission rates for patients with heart failure, heart attack or pneumonia. Instead of building senior-specific EDs, many hospitals are redesigning existing EDs to better accommodate their older patients. The senior-specific ED at St. Joseph's Regional Medical Center in Paterson, N.J., has soundproofing to create a quieter environment, non-glare flooring to help prevent falls and thicker © mattresses to help prevent bedsores. One of the country's first hospitals to open a senior-specific ED, it also provides ED nurses with specialized geriatric training. About 12 percent of annual ED visits to St. Joseph's involve seniors. A related article in the Denver Business Journal details the plans of Exempla Lutheran Medical Center in Wheat Ridge, Colo., a Denver suburb, to expand its senior ED only two years after opening it. The hospital will increase this specialty area from 2,500 square feet to about 13,500 square feet. 'Stop Sepsis' Program Reduces Mortality Rate 40 Percent M ount Sinai Hospital, New York, initiated a program called Stop Sepsis to reduce mortality on several inpatient floors and in the emergency department. As a result, sepsis mortality fell 40 percent, which contributed to a decrease in the hospital's overall sepsis mortality rate to 19 percent, according to "Mount Sinai's EMR-Based Sepsis Reduction Program Cuts Mortality by 40%," in Becker's Hospital Review. The program uses a clinician decision support model that involves data-driven, multidisciplinary protocols to quickly identify and treat cases of sepsis. As part of the program, nurses receive additional clinical training to recognize warning signs, and they call the Stop Sepsis Team (a group of specially trained nurse practitioners) if they think a patient is at risk. A team member promptly responds to evaluate the patient, order tests - such as blood cultures and additional blood work - and initiate the indicated treatment. "The success of the program is attributed to the change in culture driven by strengthened collaboration between physicians and nurses and by the development of these novel clinical decision support tools," Charles Powell, chief of the Division of Pulmonary and Critical Care Medicine at Mount Sinai, says in a related article on the hospital's website. The pilot program was introduced in May 2012 and went hospital-wide this January. EMR-based program uses a clinician decision support model with data-driven multidisciplinary protocols. 9 AACN BOLD VOICES APRIL 2014 Are SeniorSpecific EDs Worth the Investment?

Table of Contents for the Digital Edition of Bold Voices - April 2014

Another Angle
President’s Note (Teaser)
NTI2014: You Have to Come! An Unmatched Experience in the Mile High City
AACN Clinical Priorities 2014: Clinical Topics for Bedside Clinicians
NTI Network: Connect Online to Plan Your Week
Step Forward! Vote in AACN’s Election 2014
You May Inherit Atherosclerosis From Your Mummy
Pain, Agitation, Delirium Guidelines Expand Nurses’ Toolkit
Pediatric Flu Deaths Still a Concern, Expanded Vaccinations Advised
Are Senior-Specific EDs Worth the Investment?
‘Stop Sepsis’ Program Reduces Mortality Rate 40 Percent
Better Relationships Between Nurses, Cleaning Staff Can Improve Patient Care
Patient Outcomes Improve With Surgeon-Led Mortality Reviews
Reducing Cross-Contamination from Healthcare Personnel Attire
New Biomarker Could Improve Outlook in Esophageal Cancer
Long-Term Survival of Kids After Out-of-Hospital Cardiac Arrest
Tight Glycemic Control Could Shorten Children’s Hospital Stay
Web-based Patient Portals Improve Self-Management
In Our Journals
Nurse-Patient Communication Enhanced in AACN CSI Academy Projects
Link Between Shingles and Stroke Risk?
In Utero Exposure to Dyslipidemia Heightens High LDL Risk in Offspring
Palliative Care: Conversations Matter
Improving Communication About Chronic Critical Illness
Certification Capsules
April 16: National Healthcare Decisions Day
New Editorial Consults, Other Publishing Events at NTI 2014
AACN Scholarships for August EBP, Research Methods Institutes
Early-Bird Registration Ends April 3
Attend the Chapter Leadership Development Workshop at NTI 2014
Vote Now!
‘I Am a Critical Care Nurse’
President’s Note

Bold Voices - April 2014