Describe Different Levels Er

  1. Can you describe what are the different levels in the ER

    Level one
    Level two
    Level Three


    Also regarding Labor and Delivery different hospital have different levels of care. Can you distinguish between them for me. I know the more sick you are the level of the hospital will matter. However, not sure which way the numbers go since with ER I think level one is the more serious or is it the reverse

    The same for NICU...........if your baby is very sick what level hospital are you looking for I can not remember how you distinguish between the two.

    I just no the is a difference which exist. Hospital are categorized based on there ability to give care and the acuity of the patient.

    Can some one wirte it out so I can remember it for next time.

    Thanks

    Angela

    Also on a seperate distinction what qualifies a hospital to be magnum status does some one know where I go to read the criteria for magnum status
    And does any body know where you search to know what hospital in your area are listed as Magnum Status. Lastly does magnum status matter in term of pay or care from a nursing perspective? Does it really matter?
    Last edit by angelique777 on Oct 18, '05
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  2. 7 Comments

  3. by   KatieBell
    I think you are having trouble looking up Magnet hospitals due to your misspelling. Try googling Magnet hospital and you will probably have good luck to find the criteria. Same as for the levels of care.
  4. by   tomrn33186
    Quote from angelique777
    Also on a seperate distinction what qualifies a hospital to be magnum status does some one know where I go to read the criteria for magnum status
    And does any body know where you search to know what hospital in your area are listed as Magnum Status. Lastly does magnum status matter in term of pay or care from a nursing perspective? Does it really matter?
    "Magnet Status" is a friggen fraud and means absolutely nothing to the day to day practice of the average nurse.

    Magnet Status is the brain child of the American Nurses Association and it is marketed on 3 different levels.

    1 - It is sold to the public as an assurance that they will recieve excellent nursing care. ("It's a 'Magnet' hospital, it must be good!")

    2 - It is sold to the hospitals as a means of raising their profile in their community and as a way to make them seem more attractive to nurses who might think about working there. ("Look at us, we are a 'Magnet' hospital. That means we are a place you want to get treated in AND we are a great place to work for!")

    3 - It is sold to nurses as an attractive place to work. ("If it's a 'Magnet' hospital, they must REALLY care about the nurses!")

    But go to the ANA's web site and plod through their page upon page of corporate speak and you will discover that the minimum standards a hospital must meet to obtain Magnet Status are what they would meet to pass a JACHO inspection. The ANA then extrapolates that out to create an assumption/illusion that if the hospital meets those standards, it's because of excellent nursing, there for.... it must me a great place to work/recieve care.

    I have personally worked at 2 hospitals which recieved that recognition while I worked in them. And not a damn thing changed! The nurse to patient ratios were still dangerous. (I.E. 3 padiatric bone marrow transplant patients to one RN. And a tech if you were really lucky.) No raise in pay when plenty of other non magnet hospitals in the same market paid a lot more. Same crappy benifits. (Can someone explain the logic of saying you get 7 paid holidays a year, but only 7.2 hours of each day of them???) No training for new managers on how to manage people. Being overwelmed in the ER on an almost nightly basis with no help and no hope. No reasonable dispute/dicipline process. (I.E. A complaint is made, you get written up/suspended/terminated with no chance to even have your side heard.)

    All in all, in my experience, the most important criteria a hospital has to meet in attaining Magnet Status is that the check has to clear.
  5. by   mommatrauma
    Quote from tomrn33186
    "Magnet Status" is a friggen fraud and means absolutely nothing to the day to day practice of the average nurse.

    Magnet Status is the brain child of the American Nurses Association and it is marketed on 3 different levels.

    1 - It is sold to the public as an assurance that they will recieve excellent nursing care. ("It's a 'Magnet' hospital, it must be good!")

    2 - It is sold to the hospitals as a means of raising their profile in their community and as a way to make them seem more attractive to nurses who might think about working there. ("Look at us, we are a 'Magnet' hospital. That means we are a place you want to get treated in AND we are a great place to work for!")

    3 - It is sold to nurses as an attractive place to work. ("If it's a 'Magnet' hospital, they must REALLY care about the nurses!")

    But go to the ANA's web site and plod through their page upon page of corporate speak and you will discover that the minimum standards a hospital must meet to obtain Magnet Status are what they would meet to pass a JACHO inspection. The ANA then extrapolates that out to create an assumption/illusion that if the hospital meets those standards, it's because of excellent nursing, there for.... it must me a great place to work/recieve care.

    I have personally worked at 2 hospitals which recieved that recognition while I worked in them. And not a damn thing changed! The nurse to patient ratios were still dangerous. (I.E. 3 padiatric bone marrow transplant patients to one RN. And a tech if you were really lucky.) No raise in pay when plenty of other non magnet hospitals in the same market paid a lot more. Same crappy benifits. (Can someone explain the logic of saying you get 7 paid holidays a year, but only 7.2 hours of each day of them???) No training for new managers on how to manage people. Being overwelmed in the ER on an almost nightly basis with no help and no hope. No reasonable dispute/dicipline process. (I.E. A complaint is made, you get written up/suspended/terminated with no chance to even have your side heard.)

    All in all, in my experience, the most important criteria a hospital has to meet in attaining Magnet Status is that the check has to clear.
    I don't agree with all of this....I'm not saying that parts of magnet status aren't BS...but its not ALL BS...and it is a ton of work to get that status...my mother is an ER nurse manager in a hospital currently on their second level of the process, and it is a long complicated process...and I have seen the hours both she, her management peers and her nursing staff have put into this....the system is not perfect...but if it was really no big deal to be a magnet hospital...noone would ever get turned down...and people do...and everyone would have it...and not everyone does...I think maybe not all of the improvements may trickle directly down to you immediately...but I think more long term you'd see the effects of it and just know there a lot of behind the scenes improvements that you may never know were even an issue...
  6. by   NRSKarenRN
    emergency department:trauma level definitions--
    developed by american college of surgeons

    what is the difference between a level i, ii, iii, iv trauma center?





    the four levels refer to the kinds of resources available in a trauma center and the number of patients admitted yearly. these are categories that define national standards for trauma care in hospitals. the american college of surgeons developed and continues to recommended the standards and the california state trauma care systems uses the levels in its regulations.
    level i
    a level i trauma center has a full range of specialists and equipment available 24-hours a day and admits a minimum required annual volume of severely injured patients. additionally, a level i center has a program of research, is a leader in trauma education and injury prevention, and is a referral resource for communities in neighboring regions (community outreach).
    level ii
    a level ii trauma center works in collaboration with a level i center. it provides comprehensive trauma care and supplements the clinical expertise of a level i institution. it provides 24-hour availability of all essential specialties, personnel and equipment. minimum volume requirements may depend on local conditions. these institutions are not required to have an ongoing program of research or a surgical residency program.
    level iii
    a level iii trauma center does not have the full availability of specialists, but does have resources for the emergency resuscitation, surgery and intensive care of most trauma patients. a level iii center has transfer agreements with level i and/or level ii trauma centers that provide back-up resources for the care of exceptionally severe injuries.
    level iv
    a level iv trauma center provides the stabilization and treatment of severely injured patients in remote areas where no alternative care is available.




    http://www.scdhec.gov/hr/ems/trauma.htm
    http://www.dph.sf.ca.us/chn/trauma/traumadef.shtml



    levels of neonatal care.
    developed by american academy of pediatrics (aap)

    level i (basic): a hospital nursery organized with the personnel and equipment to perform neonatal resuscitation, evaluate and provide postnatal care of healthy newborn infants, stabilize and provide care for infants born at 35 to 37 weeks' gestation who remain physiologically stable, and stabilize newborn infants born at less than 35 weeks' gestational age or ill until transfer to a facility that can provide the appropriate level of neonatal care
    • level ii (specialty): a hospital special care nursery organized with the personnel and equipment to provide care to infants born at more than 32 weeks' gestation and weighing more than 1500 g who have physiologic immaturity such as apnea of prematurity, inability to maintain body temperature, or inability to take oral feedings; who are moderately ill with problems that are expected to resolve rapidly and are not anticipated to need subspecialty services on an urgent basis; or who are convalescing from intensive care. level ii care is subdivided into 2 categories that are differentiated by those that do not (level iia) or do (level iib) have the capability to provide mechanical ventilation for brief durations (less than 24 hours) or continuous positive airway pressure.
    • level iii (subspecialty): a hospital neonatal intensive care unit (nicu) organized with personnel and equipment to provide continuous life support and comprehensive care for extremely high-risk newborn infants and those with complex and critical illness. level iii is subdivided into 3 levels differentiated by the capability to provide advanced medical and surgical care. level iiia units can provide care for infants with birth weight of more than 1000 g and gestational age of more than 28 weeks. continuous life support can be provided but is limited to conventional mechanical ventilation.
      level iiib units can provide comprehensive care for extremely low birth weight infants (1000 g birth weight or less and 28 or less weeks' gestation); advanced respiratory care such as high-frequency ventilation and inhaled nitric oxide; prompt and on-site access to a full range of pediatric medical subspecialists; and advanced imaging with interpretation on an urgent basis, including computed tomography, magnetic resonance imaging, and echocardiography and have pediatric surgical specialists and pediatric anesthesiologists on site or at a closely related institution to perform major surgery.
      level iiic units have the capabilities of a level iiib neonatal intensive care unit and are located within institutions that can provide extracorporeal membrane oxygenation (ecmo) and surgical repair of serious congenital cardiac malformations that require cardiopulmonary bypass.

    magnet recognition program® developed by american nurses credentialing center the credentialing arm of the [color=#006666]american nurses association

    magnet recognition program® recognizes excellence in:
      • the management, philosophy and practices of nursing services based on ana's scope and standards for nurse administrators.
      • adherence to national standards for improving the quality of patient care services
      • leadership of the nurse administrator in supporting professional practice and continued competence of nurses, and
      • understanding and respecting the cultural and ethnic diversity of patients, their significant other, and health care providers.
    student nurses: learn about the magnet recognition program®; click [color=#006666]here to download our brochure



    out of 50 hospitals in my area, only 3 have magnet status. none of philadelphia's physician driven university medical centers have achieved this status.
    here's our latest magnet facility: main line health, october 05
    bryn mawr, lankenau and paoli achieve "magnet" recognition -- nursing's top honor!

    having received outstanding maternity nursing + son's nicu care at lankenau, and provided some private duty care there nursing truly valued.

    ----------------

    all of these "care level designations" were developed by respective professional organizations as means to identify levels of care provided within hospitals, promote highest standards, and encourage research based activities to improve patient care and decrease patient deaths.
    Last edit by NRSKarenRN on Oct 28, '05
  7. by   asha2000
    Magnet Status a JOKE!

    I just found out that my former employer passed and is now a Magnet Hospital. To me it's another case of nurse leaders being a disappointment. They talk the talk but don't walk the walk. Staff nurses being involved in decision making? HA! Quality of patient care being considered a high priority? HA! Authentic leadership? HA! Accountability? Ha, Ha! It's all a bunch of rubbish. Good nurses are leaving the profession because it is impossible to give quality patient care under the current conditions in many hospitals today. This includes so called "Magnet Hospitals".
  8. by   Miss1030
    I posted earlier a comment describing my situation in the ER ( Subject: ER Staffing) I realise that in Quebec, level 1,2 and 3 are the exact opposite of what I read from the US. A level 3 hospital (if the translation is correct from Centre tertiaire, in french) is the one with 24h readily available specialists of all kind... whereas the Level one -centre primare- is the one who can stabilise the critical pt but has to transfert it to level 2 or 3 for more specialised care.

    Hope this helps!
    Last edit by Miss1030 on Jun 28, '07
  9. by   steelcityrn
    I am not impressed with the magnet status hospital in my back yard. I hated how they tried to buy the nurses help during the process, only to dissapoint in the end. Nothing changed for the average nurse working on the floor. They are still leaving in droves.

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