Healthcare Reform

The debate on the state of the healthcare system in the United States has been raging between politicians, political pundits, and healthcare professionals. With millions of Americans living their daily life without access to health insurance, the cry for healthcare reform is no surprise. The current healthcare system not only leaves millions of Americans uninsured, but with growing prices in health insurance premiums and in health care, many Americans can not afford quality medical care. The high prices of insurance have forced many struggling businesses to pull insurance from their employees; yet, the United States spends more on health care than any other country in the world — by 52% more than the next most costly nation.

The website OurBlook, a website utilizing the dynamic atmosphere of an online blog and the researched analysis of a book, is conducting an interview series on the debate over healthcare reform. More specifically, OurBlook has gathered experts ranging from doctors to health care administrators and interviewed them about their opinion and stance on healthcare reform in the United States.

Some of the issues covered in this interview series include the debate on why healthcare reform is needed, whether “good health” incentives are feasible, and the state of health care in the United States.

There is little to no debate over the fact that healthcare reform is needed in the United States. Experts generally agree that the current system of health insurance leaves many uninsured, that government-run health care will tie up federal revenue, and that health care has become expensive and inefficient. While many Americans will claim that we have the “best” health care system in the world, the clarity of the quality of care in the United States is now in question. In fact, the World Health Organization ranks the United States as having the 37th best health care system in the world, just ahead of Slovenia.

On the issue of incentivized health insurance plans, OurBlook interviewers asked experts such as Michael Nadeau about their thoughts on the issue. Nadeau, the president and chief executive officer of Viverae, a national provider of health management solutions, agrees on the possibility of plans that emphasize the importance of preventive medicine. As he says:

“Absolutely. We definitely need health insurance policies that reward people for living healthier … following prescribed treatment plans and taking necessary medications, among other healthy living choices.”

Taking preventive measures can help to reduce health care costs by improving the health of Americans around the nation. The burden of responsibility then falls on Americans, to help themselves stay as healthy as possible. After all, why should healthy individuals be forced to pay high costs when others are not willing to keep themselves healthy?

While most experts agree that health insurance needs reform, many experts on OurBlook also agreed that health care in the United States needs reform as well. Furthermore, some experts pointed to the overall health of American society as the culprit. As Brent Pottenger, one of the top bloggers on wellsphere.com, says, health insurance is not a guarantee for healthcare, but a change in culture for a healthy society is the key. Problems such as diabetes, cancer, or cardiac ailments are seen as chronic, incurable diseases. However, this does not mean that the are unpreventable. A healthy lifestyle and healthy behavior can lower the risk of such disease, lowering the cost of health care for the individual.

The issues covered above are only some of the issues covered on OurBlook’s debate on health care reform. By sharing what our health experts think about the possibility of healthcare reform in the United States, OurBlook helps the public better understand the state of healthcare and the arguments put forth for both reform and change in culture, pushing forward the overall health of Americans.

Doctor Emergency

U. Illinois- A study conducted over a five-year period at an Illinois hospital created a pain management algorithm. The algorithm is being used to reduce the number of injuries and deaths related to errors in how pain management drugs are administered to patients in the hospital.

“A prescription is a treatment plan. And that treatment plan is, in its most general sense, an algorithm.” says Ian Brooks, head of the health sciences research group at the National Center for Supercomputing Applications at the University of Illinois.

He further explains that the processes used in developing a computer science program can further be applied to the process of prescribing medication. The definition of an algorithm is a precise set of rules for solving a problem. The study looked at prescriptions as a medical algorithm. Brooks helped create and debug the algorithm, which was tested at the OSF Saint Francis Medical Center in Peoria.

The researchers, which included nurses, doctors, pharmacists, clinical pharmacologists, quality assurance specialists and statisticians, worked with adult orthopedic surgery patients. Once anesthesia and surgical pain medications were out of the patients system, non-opioid analgesics such as acetaminophen were given. The patients were administered these non-analgesic drugs on a fixed round-the-clock schedule. This tactic cut the patients opioid medication requirements in half.

The opioid fentanyl was then given through subcutaneous catheter. The drugs were

provided via a patient controlled pump, which allowed the patients to have more control over their own pain management.

Patients reported the severity of their pain on a pain scale. The pain scale allows a patient to slide a marker to indicate the level of pain that they are experiencing. The scale went from a range of no pain on the far left, to extreme pain on the far right. Nurses would flip the scale over to see the number that corresponded to the marker placement, then follow the protocols for that pain number. The protocols also included orders to handle common post-surgical complaints such as

nausea and constipation. The algorithm has detailed protocols for responding to severe adverse reactions associated with opioid drugs.

The results of the study were very promising. During the beginning of the study there were seven severe or fatal adverse drug events (ADEs) in one month. Once the protocol was introduced and was consistently followed, the number decreased until reaching the point of zero deaths from ADEs for the final six months of the study. These results were published in Clinical Pharmacology and Therapeutics. Once the study was concluded, the protocols went hospital-wide. Since the implementation of these protocols more than six years ago, the hospital has not experienced a single adverse drug event relating to opioid-based pain medication.

“The ward nurses loved it,” Brooks says. The nurses were able to easily convert pain measurements into direct action through patient care, and, more importantly, the protocol empowered them to take action.

The protocol also opened up the around the clock use of non-prescription over the counter (OTC) analgesics to reduce the patient’s need for opioids. Maintaining the dose of these OTC analgesics managed pain in patients, reducing the use of stronger drugs.

With the leaps being made in electronic medical records and expansion of the use of computers in hospital wards, the researchers believe the time is right to pursue digital prescription protocols and expand their use.

Researchers involved in the study were from NCSA, the University of Illinois College of Medicine in Peoria, OSF Saint Francis Medical Center in Peoria, and Jesse Brown Veterans Affairs Medical Center in Chicago.

NCSA news: www.ncsa.illinois.edu/News/Stories/Painmgt/

New Jersey Hospital Nursing School

Bloomfield, NJ – The Mountainside Hospital School of Nursing has been one of the state’s oldest schools since its inception in 1892.

Now the school, one of few diploma schools for nurses in the state of New Jersey, is closing its doors for good. The school consistently enrolls 140 students a year. This year’s class, the class of 2011, is the school’s last graduating class.

The Mountainside Hospital School of Nursing is affiliated with Mountainside Hospital, a 365-bed private hospital in Glen Ridge.

Graduating over 3,100 nurses in 117 years, the School of Nursing will now combine its faculty and students into a new nursing program at Caldwell College, as the bachelor of science in nursing (BSN) has become the standard for nurses. Students who graduate from the two-year nursing program are then able to take the state test to become a registered nurse.

With the already low amount of nursing schools in the area, and the shortage of nurses in the United States medical industry, it stands as good news that Caldwell College will host its first-ever BSN program, pending an approval from the New Jersey Board of Nursing and others.

The balance between a higher standard for nurses and adequate nurse staffing levels is becoming increasingly more delicate in a time where hospitals are populated by more critical-care patients and nurses are expected to know and understand new medications.

Although the School of Nursing is closing its doors, the library and a 75-seat classroom will continue to be used by Caldwell College nursing students. The 12 faculty members on the will continue to be paid through the Mountainside Hospital payroll and continue to be faculty at Caldwell College.

The increased expectations for nurses in the medical field have led Mountainside and other nursing schools to push for more advanced training. Other nursing schools in New Jersey that suffered the same fate include the Charles E. Gregory School of Nursing and the Helene Fuld School of Nursing.

The American Nurses Association believes in bachelor’s degree requirement, as they believe 66% of the nurse workforce should have BSNs. Studies have shown that registered nurses with BSNs would save 4 lives out of every 1,000 surgical patients (according to the Journal of American Medical Association). The New Jersey Sate Nurses Association believes that nurses should obtain the four-year degree within a decade of nursing school.

One of the most historic schools in the state, the Mountainside Hospital School of Nursing has closed its doors, but has not given up on its goal of producing committed, compassionate nurses dedicated to providing high-quality health care.

Remember In The Emergency Room

For many, their next experience in a hospital emergency room may be their first. The emergency room is a place where time is more valuable than money. As such, it tends to run much differently than other areas of the hospital.

Emergency physicians are specially trained to treat emergency medical conditions. They work one of the most hectic jobs in the world — do what you can to help them help you. Remember these 5 things for your next visit to a hospital emergency room:

1. You may face a long waiting time

Each hospital has a triage system that determines what medical conditions and, therefore, patients, to treat. The priority of a life-and-death situation outweighs that of a broken arm. As such, an emergency does not work in a first-come, first-served basis. Keep in mind that every minute you wait, there is somebody else who needs more attention whose life may be saved. The hospital staff understands your frustration that comes with a long waiting period. However, since hospital emergency rooms treat millions per year, it is becoming increasingly tougher to keep the waiting time short.

2. Plan ahead for your visit

Take a little time out of your life to prepare for a medical emergency. That is, make a document that lists your prescription or herbal medicines, as well as any drug allergies or pertinent family health history. The aforementioned busyness of the emergency room means that there will be less time for you, the patient, to get your symptoms to your physician. The more information the emergency physician has about your health, the better he or she can diagnose and treat the medical condition that brought you to the emergency room in the first place.

3. You may need additional help

At times, emergency physicians will require the help of other specialists (a cardiologist, for example). Fortunately, emergency physicians are specially trained to assign the right help to treat your particular medical condition. Emergency physicians are specialists themselves — they are quick thinking and flexible and are trained to treat all types of medical emergencies.

4. Understand what an emergency room is for

Many patients enter the hospital emergency room for general health care such as physicals or vaccines. The hospital emergency room is there to help you with emergency acute care, not to check whether or not you are allergic to peanuts. When you show up at the emergency room, make sure you are able to tell the physician specific, descriptive symptoms. Dispense the information that your physician needs as quickly as possible.

5. Take care of yourself, even after leaving the emergency room

The hospital emergency room directs patients in the right direction with medication, treatment, and advice. Make sure that you understand your diagnosis and treatment plan from your emergency physician before you leave the emergency room. Always inquire about follow up care, medication plans, or activity restrictions. Keeping an open communication between your physician will allow better care.

Hospital Holiday Tips

A trip to the hospital during holiday festivities is a sure-fire way to ruin the end of a year.

The holiday season brings happiness and joy to all with its decorations, twinkling lights, Christmas trees, and carols. Unfortunately, these happy times also bring increased risk for the health of the public. The holiday season can bring health concerns ranging from hospital emergency room visits for ingested ornaments to hospital admissions for drunk-driving accidents.

The many activities and errands that come with the holiday season may cause many people to pay less attention to safety and end up in a hospital emergency room. Hospitals and their emergency physicians urge people to take a bit of time and care during the holiday season, and to never drink and drive, no matter what the color the leaves are.

More than 12,000 people are treated at a hospital emergency room each year due to falls, cuts, shocks, and burns from holiday decorations — either from faulty equipment or accidents, according to government statistics. Furthermore, the holiday season brings more parties, where people are more likely to consume alcohol. Remember these tips the next time you are aching to leave your Aunt Leslie’s house in Stamford after an eggnog:

1. Stay safe while traveling

Traveling during the holiday season can be hectic in its own right, with parents and frantic teenagers racing to and from malls, all hoping to do last-minute Christmas shopping. Remember to always wear seatbelts at all times, to place your children under 12 years of age in the back seat and secure all young children in appropriate safety restraints for their ages and sizes. NEVER drink alcohol and drive, especially during the holiday season. Nobody wants to visit the hospital emergency room, let alone force someone else to do so.

2. Stay safe outdoors

As excitement for opening gifts grow, temperatures drop. Always clear snow and leaves from pathways and sprinkle salt on patches of ice to avoid accidents. Check your child’s shoes, socks, and gloves to make sure they are dry when they play outdoors in the snow. Frostbite and hypothermia are no joke — and can lead to a hospital trip.

3. Keep decorations safe

Ensure that your holiday lights are not broken and that the wires are not damaged. Always turn off lights before leaving your house and avoid using sharp decorations and ornaments. Keep Christmas trees away from fireplaces or other areas where high heat is present. Choose the right ladder for any decorating job and never do it alone.

4. Keep fire in the fireplace

Keep burning candles and lighters away from children, and keep fire hazards away from your holiday log. Remember to get a yearly inspection for chimneys and fireplaces.

All of these tips are aimed at keeping you and your family way from the hospital emergency room during the holidays. Spend your time spreading holiday cheer and creating gingerbread houses — not waiting in line in the hospital emergency room to get a glass ornament out of your son’s stomach!

Child to The Emergency Room

A child suffering from a serious medical condition may need to visit a hospital emergency room. The truth is, bringing your sickly child to the emergency room can be one of the most frightening experiences of one’s parenting life. The emergency room is a place that can instill fear in a young child. There are many other sick people around, being attended to by emergency physicians and nurses trained to work in a fast-paced, busy environment. For your child, all of this can add up to a frightening experience.

Since your child may be nervous and scared, it is important for you to remain calm and act as a parent. Let your child know that you care about them, and that hospitals are a place for healing and getting better, not a place where they should be scared. Moreover, you must also act as the health advocate — making sure that the entire emergency room process runs smoothly. Below are some tips to help you make your child’s first hospital emergency room visit:

1. Plan ahead

Before your child has their hospital emergency, always be aware of the hospital closest to you that accepts your medical insurance. You should also plan for transportation — make sure you have a way to get to the hospital.

2. Call 911

Remember that in a life-or-death situation, you should call 911. If you know it is safe to drive, remember that keeping calm will in turn keep your child calm.

3. Communicate with the staff

Hospital emergency rooms are hectic places. Remember to keep an open communication with the emergency physician to ensure proper diagnosis and medical treatment. If possible, prepare a medical history document of your child including any allergies, previous medical conditions, or medications.

4. Communicate with your child

As said before, your child may become frightened from their condition or the hospital environment. Stay calm and remain sensitive to the situation, but be honest. Remind them again that the hospital is there to help them get better, and that the emergency room physicians are examining them in order to help.

5. Bring an overnight bag

In case your child is admitted to the hospital, you should have a bag containing a change of clothes, toys, pajamas, or snacks to facilitate your his or her stay. Remember not to let your child eat or drink anything until a physician offers a recommendation.

The most important thing you can do as a parent and health advocate is to remain calm. Doing so will make the hospital emergency room experience much more bearable for you, your child, and the hospital staff. Children feed off of subtle signs of their parents and, therefore, you should do everything in your power to avoid being impatient or panicked. The emergency physicians are doing the best that they can to attend to each person’s medical needs — avoid making a difficult situation even worse.

Bringing your child to the emergency room can be a nerve-wracking experience, but it doesn’t have to be. Remember these tips in case an emergency presents itself.

Doctor and Patient

The Baby Boomers are growing elderly; and with medical research continually innovating, the average age of Americans continues to increase.

Those who are taking care of an elderly parent or loved one can benefit greatly from planning ahead for a possible visit to a hospital emergency. When you are forced to rush to a hospital emergency room, the experience can be difficult and stressful. Even so, you will be expected to answer a lot of important questions and provide pertinent health information on the spot.

The importance of being prepared when visiting a hospital emergency is not to be understated. The emergency room is different from other areas of the hospital for a few reasons. First, time is a much bigger factor in the emergency room, as all the patients visiting the room are there for a medical emergency. Second, the physicians and nurses present in the emergency room are often trained as emergency professionals, and will likely request quick and accurate information. Last, the emergency room can cost thousands of dollars more than a normal hospital inpatient visit, making each visit that much more important.

Here are 5 tips for a person bringing and elderly patient to a hospital emergency room:

1. Bring Reading/Entertainment Materials: Bring a book or newspaper to read while you are waiting for results or waiting to see a physician. Where the Red Fern Grows may not reduce your stress level, but a Calvin and Hobbes book may do the trick.

2. Anticipate Admission: Should the patient or parent be admitted to the hospital, you will need to bring a change of clothes and personal care items. You can keep these in the car until after you see the physician, but it may save vital time should they be needed.

3. Fill out a Medical History Form: Search the Internet for a form that you and your loved one’s physician can help you complete. Remember, being prepared is the key! Remember to list the medications, allergies, and past and present medical conditions of your loved one. Bring the completed form to the hospital emergency room to give to the emergency physician.

4. Be the Advocate: Being the health advocate for your loved one can make your emergency room visit much more bearable. You know the patient better than the emergency physician, so it is your job to help the physician better understand his or her patient. Take down notes and make sure that your loved one is receiving the proper care and medication. Do not let the patient downplay their symptoms, as it may affect diagnosis and treatment.

5. Be Patient: A hospital emergency room can be one of the busiest and most frantic places in world. The more complaints, the longer it takes to work up the problems. Do not create more problems for your loved one or the other patients in the emergency room waiting room.

Emergency Room for H1N1

The H1N1 Flu pandemic has created panic across the entire world — and in hospital emergency rooms across the nation. Many hospitals have already started H1N1 readiness and awareness initiatives, aimed at informing the general public and H1N1, its symptoms, and tips for how to deal with the swine flu.

For the few who have already been vaccinated from the H1N1 disease, the following information will likely not be necessary. Vaccination is the best protection against contracting the flu, and it is highly recommended that all who have access to the vaccination, either through a clinic or hospital, should get vaccinated.

For the nearly 1 in 6 Americans that have been infected by the virus, however, it is important to stay informed about the H1N1 and its potential deadliness. Specifically, this article is written to help you better understand when you should consider visiting a hospital emergency room.

Since the emergency room is reserved for injuries of serious nature, deciding whether your flu-like symptoms warrant the use of the local hospital emergency room can save unnecessary hospital bills and valuable time. As the emergency room is often very busy and expensive, consider visiting a clinic, or your family physician before choosing to go to the emergency room.

However, if you are suffering from the follow symptoms, you should immediately visit a hospital emergency room as soon as possible. If you:

* feel feverish, have a cough or sore throat
* have difficulty breathing or chest pain
* breathe over 24 breaths per minute
* have purple or blue discoloration of the lips
* are vomiting and are unable to keep your liquids down
* are confused or experience a change in either behavior or alertness
* show signs of dehydration including headache, extreme thirst, dizziness, and decreased urination
* experience convulsions or seizure

If you are experiencing any of these symptoms, you are likely not suffering from the H1N1 virus and do not need to visit an emergency room. However, if you have any of the following conditions and are experiencing a fever, cough, or a sore throat, you may want to see your family physician or a walk-in clinic:

* Aged 65 or older
* Diabetes
* Pregnancy
* Obesity
* Have a transplanted organ
* HIV/AIDS
* Chronic Heart Disease
* Sickle Cell
* Received chemotherapy in the past month
* Cirrhosis
* A disease the weakens the muscles
* A disease that makes it hard to think such as stroke, dementia, or Alzheimer’s

For those thinking about visiting a hospital for the H1N1 swine flu virus, keep these symptoms and conditions in mind. If you are not suffering from one of these symptoms or conditions but still feel sickly, stay at home (either from work or school) and rest up until you feel better. Take over-the-counter medicine such as acetaminophen o ibuprofen to reduce your fever. Also, you should rest, eat well, and drink a lot of fluids.

Visiting the hospital emergency room when you are in need of a medical emergency can save your life. However, if your medical condition is not requiring emergency medical care, unnecessarily visiting an emergency room can cost thousands of dollars. Remember to get the seasonal flu and H1N1 vaccine if it is available and to always wash your hands frequently with either soap and water or an alcohol hand sanitizer.

Improving Medication

The Institute of Medicine’s July 2006 report showed that medication errors harm an estimated 1.5 million people in the United States each year, costing nearly $3.5 billion in unnecessary hospital costs. The statistics are staggering — each hospital patient may be victim to one medication error each day.

A wrong prescription or misunderstanding can lead to patients taking a medication that is not necessary, and potentially harmful. The problem for hospitals is that medication errors are largely preventable, and should not pose such a significant problem.

There are over 40,000 different medication names in hospitals around the United States, a number that continues to grow. As there are only so many combinations of names possible, it comes as no surprise that many hospital drugs have similar names. Furthermore, hand-written prescriptions or abbreviations can also pose problems in medication. In this case, the patient should be the first priority. Hospitals should reduce the amount of changes made to the patient’s clinical status or patient transfers to other hospitals or hospital areas gives another opportunity for misinterpretations.

Here are some practical tips that every hospital can take to improve medication safety, as given by Joint Commission Resources medication safety practice leader, Jeannell Mansur:

Better Communication: The most important thing to reducing medication errors is increased communication with patients. Open communication allows patients to be advocates for their own health, especially in hospital settings. Hospitals should aim to encourage patients to be actively engaged in their own health care.

Keeping Records: It is also important for hospitals to maintain a record of patients’ medications and to discuss any over-the-counter or vitamins that he or she takes. It is critical for physicians to know in detail what the patient takes at home to avoid circumstances when a medication may need additional monitoring.

Involving the Pharmacist: Since the hospital pharmacist is responsible for dispensing prescription medication, it can be very beneficial to involve him or her more actively in patient care. The hospital pharmacist can provide education to patients about the medications they take, or make recommendations on medication changes.

Double-Check: Hospital medication systems should detect the error as quickly as possible. Double-checking medication, especially those that are high-risk in hospitals, can prevent the possibility of many errors. An independent double-check, or a second person going through the whole process, was found to detect approximately 95 percent of errors.

Hospitals should keep these four medication safety tips in mind at all times. Medication errors in hospitals remain one of the most preventable causes of death and excess spending in all of health care. The increased communication between patients, physicians, and pharmacists can reduce medication errors. Additionally, hospitals and their leaders should encourage increased teamwork and open communication between hospital workers. With a collaborative effort, there is no reason that medication errors should not go down. The increase of awareness surrounding patient safety has led to the realization that hospitals can take small steps to increase the quality of health care offered to their patients.

Women's Risk of Heart Disease

Here’s a fact that you may not have known: 1 out of every 3 women die of heart disease. Heart disease is still the leading cause of death around the nation, killing more people than all other causes of death combined, including all forms of cancer. In fact, women are up to 6 times as likely to die from heart disease as breast cancer.

Hospitals around the nation are constantly dealing with patients who walk into the emergency room, complaining of chest pain. The problem for these hospitals is that symptoms in women are often different from symptoms in men, and as heart disease is considered more of problem for men (a stereotype, as more women die from heart disease than men every year), more awareness is required on the issue.

The most common symptom of a heart attack is always some sort of pain, pressure or discomfort felt in the chest. However, when a woman walks into a hospital with a high-risk of heart disease, the “most common symptom” is not always the most prominent symptom. Hospitals should be more aware of symptoms more specific to women, that is:

* Shortness of Breath
* Nausea or vomiting
* Sweating
* Unusual Fatigue
* Dizziness
* Discomfort in the neck, shoulder, upper back or abdominal region

The problem lies in the lack of the “defining symptom” in heart disease for women. Many women show up in hospital emergency rooms after heart damage has already occurred, as their symptoms are not those that are usually associated with a heart attack. Traditional heart disease risk factors specifically playing a bigger role in women are metabolic syndrome, mental stress and depression, smoking, and low levels of estrogen. If you experience any of the symptoms or are at high risk, call for emergency help immediately. Do not drive to the hospital on your own!

So what can a woman do to reduce their risk of heart disease? Here are 5 quick tips:

1. Stay aware

Always stay aware of your symptoms and risk factors, and always be prepared by knowing what hospitals are around you, and which hospital your insurance allows.

2. Talk with your doctor

Keeping an open communication with your hospital or family physician is important. Schedule an appointment with your physician to better understand your own personal heart disease risk.

3. Quit Smoking

Smoking is more damaging to the body in women than in men. Not only does it increase your risk of heart disease, it also brings many more risks along with it. Smoking is the most preventable cause of death in the country, yet 140,000 women die from smoking relatd causes each year.

4. Exercise

Staying out of the hospital can become more of a reality if you exercise 3 to 5 times a week. Studies have shown that proper exercising and physicial activity can significantly lower your risk of heart disease and cancer.

5. Diet properly

Obesity is a major cause of heart disease. Work with a nutrition or ask your physician about how to eat for a healthier heart.