Do you think this will improve staffing?

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I was informed at work the other day that Medicare the almighty will no longer pay hospitals for: Hospital acquired infections, Hospital acquired bedsores, DVT'S or IV infections. Is this true? If it is, my thought is this...with better and safer staffing levels these things can be much more readily prevented. Do you think that MAYBE someone in administration will get the clue that if they provide adequate staffing levels on the units they will in the long run save themselves money? I mean surely it is cheaper to pay for an extra aide, LPN or RN (or 2, or 3) on the floor and avoid the costs of 5 extra days with all the expenses that go along with the listed complications. Or am I asking too much to think that ANYONE in administration has COMMON SENSE?:lol2:

:deadhorse:banghead::lol_hitti

Specializes in ER/EHR Trainer.

I think this will only cause us all to have to work harder. These are the following medicare rule parameters being instituted in 2008.

Injuries resulting from a fall in the hospital.

Reactions when transfusion patients get the wrong blood type.

Air embolism, when air invades the blood stream.

Bed sores that patients develop while in the hospital.

Objects, such as sponges or surgical tools, left in patients during surgery.

Noscomial infections.

Central line and foley induced infections.

Only hospitals that don't deal with "sick" patients will have anything good to report. In our area, we have a gazillion nursing homes, rehab, assisted living, and elderly which are poorly cared for.

Foleys come in crusty and nasty-no UTI? You've got to be kidding! Great in young healthy people in for surgery or temporarily laid up. Bad for all who really need it longterm-solution, remove it. But by the way, if no staff to assist in toileting.....leads to

Bedsores, skin tears, ugh! Not enough people to help with toileting so we sit in our waste and skin breaks down. How do you heal or prevent on someone who isn't eating, or eating poorly?

PE's come in every week, many of these people are post op by several weeks! How are you going to prove where it came from? Common post op side effect.

Falls, you've got to be kidding. With the great restraints roll back last year, can't get anyone held down or chemically restrained without tons of paperwork. Patients are a danger to themselves, and many families don't care! Can't or won't be bothered to sit with confused, older, frail patients.

Central line infections-ez to get-patients don't follow protocol and it is a proven fact that eventually every line will become infected. What I don't get is that only the sickest of the sick get them. If your immunological defenses are down already-who can possibly imagine that a port, picc, or any other line isn't going to eventually become infected? So does that mean, the treatment for infection isn't covered. Or, the replacement? or? You could go on and on.

Wrong blood type-I agree.

Tools left behind-I agree.

Only God knows what is brewing in these people!

I am really disgusted with these rules. We have nursing homes and assisted living facilities placing mattresses on the floor rather than restraining people to prevent falls. It's ridulous-how is a rehab patient supposed to get off the floor with hip replacement? Can't get them moving off of a high surface.

They used to laugh at me when I checked someone over head to toe in ER-I always documented entry condition-never wanted to be blamed for patient reaching the floor without full report. So many nurses never look even on the floor-so if it isn't passed on, it isn't mentioned.

Don't know how we will deal....I already think we work to hard.

Maisy;)

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I Do you think that MAYBE someone in administration will get the clue that if they provide adequate staffing levels on the units they will in the long run save themselves money? I mean surely it is cheaper to pay for an extra aide, LPN or RN (or 2, or 3) on the floor and avoid the costs of 5 extra days with all the expenses that go along with the listed complications. Or am I asking too much to think that ANYONE in administration has COMMON SENSE?:lol2:

:deadhorse:banghead::lol_hitti

We can do lots of praying, but NO I don't think a lot of admins and docs will get it. I just see this really p-o-ing many docs who will not be paid for dealing w/ pts. problems they will blame on the nursing staff. "If you had gotten Mrs Doe oob, she wouldn't have this DVT no one is going to get paid for. I can hear it now.
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Specializes in Hospital Education Coordinator.

The lack of common sense is not restricted to managers. I audited a chart in which 8 diferent nurses on 3 different units (ER, ICU, MedSurg) had "assessed" an elderly patient. One day she did not have a pressure ulcer, the next day it was Stage III and the next shift it would magically disappear again. She ended up with an amputation.

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Obviously someone was smokin' something when they thought that making these new rules would fix things.

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Can someone provide a link to these 'rules'?

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Specializes in Med-Surg/Tele, ER.

I found another article on this, I found it quite helpful:

http://news.nurse.com/apps/pbcs.dll/article?AID=/20070924/CA09/309240012

I have to say, I'm really afraid of how this will pan-out in my institution. Swabbing at admission will go a long way.

My institution just chopped our end-of-year bonus in half because our Pres-Ganey scores were "good, but not good enough", one can imagine how they might handle this Medicare issue.

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Specializes in ICU. Med/Surg: Ortho, Neuro, & Cardiac.
Sad to say, they probably won't increase staffing. What they will probably do (and what some facilities are already starting to do), is start testing patients for MRSA by nasal swab when they are admitted. If the pt is found positive for MRSA upon admission, the cost of treating it will fall on their shoulders. The hospitals can then say it wasn't incurred during that hospital stay.

At the hospital where I work, a pt is put on contact isolation if they have a HISTORY of MRSA, VRSA, VRE, or have had a spider bite or boil within the last three months.

Is this a common practice?

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At the hospital where I work, a pt is put on contact isolation if they have a HISTORY of MRSA, VRSA, VRE, or have had a spider bite or boil within the last three months.

Is this a common practice?

It is in some of the places I've worked. Then after 3 consecutive negative surveillance cultures, the isolation is discontinued.
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Specializes in ER, Occupational Health, Cardiology.
It is in some of the places I've worked. Then after 3 consecutive negative surveillance cultures, the isolation is discontinued.

The same policy is in effect at the hospital I worked at.

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Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.

It is in effect in several hospitals in my area, too.

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Specializes in Hospice, Med/Surg, ICU, ER.
We are doing this - we swab every single patient that is admitted to our ICU.

Us too.

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