Nursing management
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The third version of the Health Plan Employer Data and Information Set (HEDIS) has been revised for 1998. Many changes affect either the clinical codes that determine whether a member received a service or the content of the service being measured. The updated version contains 15 fewer measures than did its predecessor.
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Survival from in-hospital sudden cardiac death has not improved in the last 30 years. After reviewing one hospital's arrest events, their emergency response, automated external defibrillation and the current American Heart Association guidelines, a course to improve survival was initiated. Providing early defibrillation is a critical first step to improving outcomes from sudden cardiac death.
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Point of care testing is changing for the better the way we practice medicine. Whether it is an anesthesiologist doing a blood gas in the operating room, a nurse measuring serum glucose in the home or on the unit, or an intensive care nurse testing by the bedside before calling an intensivist, newer instrumentation provides for a limited number of quality tests to instantly add value to the critical decision-making process of modern staff. This movement is a true paradigm shift that will reduce unnecessary testing, provide timely measurement of critical values and avoid unnecessary and catastrophic mistakes.
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This is a tale of successfully building an interdisciplinary team in a stressful and rapidly changing ambulatory environment. It uses a framework where the leader does not have direct control over the assets but tries to influence the group to build trust, improve communication and collaborate toward common goals.