kbprn1

OK-I will not rehash all that has been said here, however, I am getting more and more concerned with how some nurses do not "believe" in the flu shot. The evidence of the risk/bennefits of flu vaccine far outweigh quite a lot of the evidence for other interventions our medical colleauges recommend on daily basis and that payers and the government recommend. We still have all kinds of uses of drugs for reasons they weren't even FDA approved. I coordinate chronic disease maintenence and prevention in a small hospital and a clinic with about 40 providers. We audit prevention hard, every month. Inicluded in these audits are flu, pneumovax and tetorifice shots. Are infection control nurse also requires any employee who refuses an annual flu shot to sign a waiver. Our facility hits about 80% employees having the flu shot every year, and during flu season, about 65% of our patients get vaccinated. We also have a protocol in our clinic so nurses can give the flu shot prior to the physician seeing the patient during the visit. What I have noticed is a relationship between the performance of the nurses who decline their own flu shot and the percentage of their patients recieving the vaccine. Their bias appears to be clearly affecting the vaccine rates OF THEIR PATIENTS! While some teams have over 80% of their patients vaccinated, some non-vaccinated nurses have 40%. If you, as a nurse, don't feel vaccinations are in your best interest, then you are making a personal choice that still may affect the health of your patients if you transmit a bug to them. While you have a right to make personal choices, I am aware of some facilities beginning to mandate the flu shot for patient care employees. However, if you let your personal biases affect how you care for patients by implicitly or explicitly not promoting the flu shot, I believe you are not practicing very professionally. Besides, the costs of an elderly person getting the flu and being hospitalized are significant. You may think the risks for you, as a healthy person outweigh the bennefits (even though science would beg to differ), the risk/bennefit ratio changes for those with chronic diseases like diabetes. Please take a step back and make sure you are not unintentionally projecting your biases on your patients.

Hi all- My first post. I work in an approximately 20 provider clinic that has just become provider based with our hosptial. In other words, we are held to all remotely applicable hospital Joint Commission standards. We are struggling to figure out Medication Reconciliation in our clinic setting. Inpatient MedRec is pretty straightforward. Outpatient is not so much. Currently, a nurse or MA takes or re-clarifies a written med history in our paper chart with the patient. The provider then sees the patient, and may order new meds, take them off others, or whatever. Within 48 hours the provider dictates a note for the visit, and the nurse many times doesn't see the patient after the provider. Currently, many of our providers do not dictate a full and complete list of meds after each visit. Many of our patients are not given any kind of list of their meds when they leave the clinic. Are any of you working under the same technological handicaps (no electonic medical record) and finding a way to do this that meets the standards????