Sick of core measures

[WindyhillBSN]

Our hospital is trying to get magnet status, and there is a bunch of rules on discharging patients within the core measures. If we mess up they're going to write us up. I'm sick of it. If you make a mistake they hang it up for everyone in the hospital to see... Anyone else have core measures?

[RNKPCE]

Like previous posters said Core Measures are indirectly used for Magnet Application. CMS requires them and some of the Core Measures are Nursing Sensitive Indicators(NSI) and those are required for application/reapplication to Magnet Status by ANCC.

[blondy2061h, MSN, RN]

Ah, that's why I've never heard of it. We don't get those diagnoses on my unit.

[maxthecat]

The concept sounds good. My gripe is that if and when they are implemented at my hospital, I'm certain that the nurses will be held accountable if a physician doesn't order something, not the physicians. Right now, we are told that we nurses are accountable to make sure that the discharge meds ordered are reimbursable by medicaid, and if they are not, we are responsible for notifying the physician and getting them to write for another med or sign prior approval paperwork (which we fill out for them). If a patient slips through, we are held accountable, not the physician. When I asked why it is my responsibility to essentially "babysit" the doctors, I am told that it is a nursing responsibility, the doctors are too busy to keep up on this, and we need to help them. "This hospital expects teamwork from its employees." I'm still looking for the people who are supposed to help me with my responsibilities but I've never seen them. (Aides excepted of course!)

[AnnaN5]

We use core measures at our facility and on my cardiac unit we pretty much see all of them: stroke, MI, CHF, etc. There is a core measures sheet on the front of every chart but it is the case management's responsibility to audit the chart and make sure everything is being met before discharge. Also all of those diagnosis have standard order pathways that they are put on the include everything the doctor would ever need to order. For example the stroke pathway has GCS, CT, MRI/MRA, anticoagulation, etc. and the MI pathway as the aspirin, beta, etc. Makes it pretty easy for the doctors and we don't have to try and remember what each patient diagnosis needs for orders. We just ask the doc if they want them on the stroke, pneumonia, CHF, ACS pathway, etc. We are responsible for education at discharge but that is pretty much all that falls on the nurse.