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The Capital Project Essay

The Emergency Room

The Emergency Room at Good Samaritan Hospital Medical Center (GSHMC) is one of the busiest on Long Island. GSHMC maintains the prestigious status of being a Magnet designated hospital as well as a level two trauma center (Good Samaritan Hospital Medical Center [GSHMC], 2012). GSHMC has five hundred and thirty seven beds and is a not-for-profit hospital. The Emergency Room sees over one hundred thousand patients per year (GSHMC, 2012). The patient population is mainly from the South Shore of Long Island, NY. The services provided at GSHMC cover all aspects of patient care and medical disciplines including Pediatrics. Presently the pediatric population includes infants, children, adolescents, and young adults up to twenty one years of age. GSHMC has the only Pediatric Emergency Room in the Suffolk County area (GSHMC, 2012).

The Pediatric Trauma Room

The Pediatric Trauma Room is armed with state of the art life-saving equipment that is used daily in the treatment of emergent and critical patients. The pediatric population differs from the adult population primarily because treatments and medication dosages are based on the patient’s weight (Emergency Nurses Association [ENA], 2012). Recording incorrect weights for the pediatric population in the Emergency Room can cause harm and can potentially cause death or permanent damage beyond that of their original emergent ailment/ incident. Pediatric medication errors are considered the most common and also the most avoidable (ENA, 2012). Obtaining the pediatric patient’s correct weight is considered an integral and mandatory element of the nursing assessment (ENA, 2012).

The ability to obtain that weight quickly and accurately is of the upmost importance in an emergent situation. Presently a length-based tool called the Broselow Pediatric Emergency Tape is utilized to estimate the pediatric patient’s weight in emergent situations (Frush, 2003). The use of the Broselow Pediatric Emergency Tape does not remove the requirement of an actual and accurate weight. Often an actual weight is not achieved until the patient is admitted onto the Pediatric unit. Unfortunately, the estimated weight in the pediatric population often leads to improper dosing and should only be utilized in extreme emergencies (Emergency Nurses Association, 2012).

The Procedural Stretcher with IntelliDrive® Powered Transport has a purchase price of eleven thousand dollars (Krulikowski, 2012). The stretcher is fully powered, and equipped with: IV poles, supply storage, dual scale (Pounds/Kilograms), simple one touch auto start and stop, ergonomic handles, and a specialized halo feature to support airway lines and IV tubing for the transport of intubated patients. The Procedural Stretcher with IntelliDrive® Powered Transport will enable pediatric trauma patients to be weighed immediately upon arrival into the trauma room. The stretcher will also support and secure all of the essential life-saving equipment for transport to the Pediatric Intensive Care Unit (PICU). The journey to the PICU is one quarter mile away from the Trauma Room. The hallways are winding, narrow and parts of the trip are actually uphill making the transportation of a critically ill patient even more challenging. The Procedural Stretcher with IntelliDrive® Powered Transport offers a smooth and safe alternative to pushing a heavy stretcher.

Safe Patient Handling Saves Money

Back injuries and Muscular Skeletal Disorders (MSD’s) are extremely prevalent in the health care field. This is especially true for nurses and health care staff who must frequently and physically move patients (Menzel & Nelson, 2010). Back Injuries and MSD’s can directly be related to: a decreased workforce due to injuries which can then cause further short-staffing. In fact the US pays out seven billion dollars related to the consequences of staff injuries (Menzel & Nelson, 2010). Management must remain cognizant of the dangerous conditions that are too often secondary to short-staffing (American Nurses Association [ANA], 2011).

The injured health care professional may eventually need to change their career path secondary to permanent MSD’s (Menzel & Nelson, 2010). Recent studies report a sixty thousand dollar annual reduction in medical costs when safe staffing is maintained (ANA, 2011). Additionally, reduced malpractice claims, payouts, readmission, denials and fines will be experience when adequate staffing is maintained (ANA, 2011). Most noteworthy, the patient’s may experience less pain or suffering and therefore better outcomes can be anticipated with safe staffing. This sends a clear message to management; powered devices are an investment that can reduce staff injuries while also ensuring the safe handling of the patients as well.

Increased Productivity

Staff injuries that include lower back discomfort and MSD’s are considered of the most common amongst healthcare professionals (Liebert, 2007). Recent articles reflect that a staggering seventy percent of staff injuries are related to direct manual patient handling and transfers (Liebert, 2007). Staff injuries negatively affect productivity levels secondary to lost time (Liebert, 2007). This often creates a viscous cycle leaving less staff to care for more patients. This in turn increases the risks for experiencing an injury onto the overburdened and overwhelmed staff. The use of the Procedural Stretcher with IntelliDrive® Powered Transport will decrease the risks of experiencing these injuries and increases productivity (Krulikowski, 2012). In the Emergency Room setting the use of the Procedural Stretcher with IntelliDrive® Powered Transport will help by reducing physical and mental stress as well as turnaround times (Krulikowski, 2012). The consistent culture of nursing has always demonstrated the patient’s needs and safety as their priority (Liebert, 2007). Often this culture neglects the nurse’s health and well-being for that of the patients (Liebert, 2007). The Procedural Stretcher with IntelliDrive® Powered Transport enhances both staff safety and patient safety (Krulikowski, 2012).

Quality Assurance

Quality Assurance measures can be utilized to reflect how the Procedural Stretcher with IntelliDrive® Powered Transport can decrease the incidence of staff injuries and inaccurate patient weights (Harris, 1986). With the use of Quality Assurance, data can be utilized to demonstrate that the Procedural Stretcher with IntelliDrive® Powered Transport can actually prevent staff injuries and improve patient outcomes (Krulikowski, 2012). Quality Assurance activities help nurses to be autonomous by enabling them to monitor and assess their own performance. Quality Assurance also helps to pinpoint areas that need improvements and therefore allows nurses to develop remedies that reflect the best professional practices. The use of Procedural Stretcher with IntelliDrive® Powered Transport positively impacts multiple issues that affect the quality of patient care.

Enhanced Economic Environment

In the Emergency Department increased patient flow often results in improved patient satisfaction as reflected by positive patient satisfaction survey responses (Hospitals & Health Networks [H&HN], 2007). Increased revenues can be experienced secondary to assessing, treating, and evaluating more patients. After treatment patients are either admitted or discharged. The faster the process, the more patients the Emergency Department can see and evaluate which can result in increased revenues (H&HN, 2007). The Procedural Stretcher with IntelliDrive® Powered Transport offers the ability to enhance the Emergency Room’s patient flow.

Improved Patient Care

Enhanced patient care can be experienced secondary to the use of the Procedural Stretcher with IntelliDrive® Powered Transport (Krulikowski, 2012). The special features of the Procedural Stretcher with IntelliDrive® Powered Transport allow for enhanced care to occur. Accurate weights can be obtained upon arrival without needlessly moving the patient onto a scale. Every time the intubated patient is moved the staff risks losing the patient’s airway by accidently displacing their endotracheal tube (Swift, 2011). All equipment must be secured and appropriate for the transport. No equipment should be jury-rigged because this can lead to equipment mishaps (Swift, 2011).

According to Swift adverse events of varying degrees of severity occur in as many as fifty percent of critical transports involving intubated patients (Swift, 2011). Many of these events can be associated with the equipment, the staff and the status of the patient. With the use if the Procedural Stretcher with IntelliDrive® Powered Transport equipment, airway tubing, IV tubing, oxygen tanks, ventilators and IV pumps can be safely secured to the stretcher avoiding dangerous mishaps (Swift, 2011). The end result of utilizing the Procedural Stretcher with IntelliDrive® Powered Transport is a smooth and seamless transfer which can potentially lead to better patient outcomes (Krulikowski, 2012).

Cost Containment

The utilization of the Procedural Stretcher with IntelliDrive® Powered Transport can minimize and contain costs related to: equipment damage from transport mishaps, workman’s compensation secondary to employee injury, malpractice claims related to adverse advents with poor patient outcomes (Swift, 2011). With the use of the Procedural Stretcher with IntelliDrive® Powered Transport less staff will need to accompany the patient in an attempt to secure the equipment and push the stretcher. The use of less staff during critical transports allows for cost containment to occur resulting in greater efficiency of scares resources. The use of the Procedural Stretcher with IntelliDrive® Powered Transport with onboard patient scale can help to reduce medication errors in the pediatric population (Emergency Nurses Association, 2012).

Presently medication errors rank as the eight leading cause of death in the United States (National Conference of State Legislatures [NCSL], 2011). The rate of deaths due to medication errors surpasses that of breast cancer, car accidents and even AIDS (NCSL, 2011). Every year almost one million patients are harmed by preventable medication errors (NCSL, 2011). The yearly cost of these medication errors is over nineteen billion dollars (NCSL, 2011).

The Community

The community benefits from having a level two Trauma Center and hospital within driving distance of their homes. GSHMC is open to the community and is known for accepting all patients; even those that other hospitals have turned away (GSHMC, 2012). In order to stay competitive, efficient and safe; assistive devices such as the Procedural Stretcher with IntelliDrive® Powered Transport must be purchased and utilized. GSHMC provides health care and much needed employment opportunities to the community.

Many of the nurses employed at GSHMC live in the local communities surrounding the hospital. This adds value to the community and revenue to local businesses. The local community expects the best care at GSHMC and to uphold their Magnet standards of quality GSHMC must invest in state of the art equipment that supports the best nursing practices and care as evidenced by research. Typically, patients want to go where they believe they will get the best care and nurses will remain employed where they are fostered to provide that care.

The Stakeholders

The stakeholders are the investors, administration, management, employees, physicians, payers, vendors, and the patients served (Duke University Medical Center, 2005). The stakeholders want to see that GSHMC is investing in quality equipment or services (Duke University Medical Center, 2005). State of the art equipment that enhances patient safety and reduces expenses or prevents them actually speaks volumes to stakeholders. Adverse events bring up questions of staff competence and may cause the community and stakeholders to lose confidence in the care that is given. Stakeholders want to see that projects are aimed at improving the overall good of the hospital and not just one party (Duke University Medical Center, 2005).

Justified Capital Purchase

The purchase of the Procedural Stretcher with IntelliDrive® Powered Transport can be linked to GSHMC short and long term goals. The safe emergent treatment and transport of the critically ill child to the PICU falls under the category of short-term goals. The long term goal of improved patient outcomes secondary to the use of the Procedural Stretcher with IntelliDrive® Powered Transport shows growth and innovation to promote safer practices. GSHMC has the only Pediatric Emergency Room in the Suffolk County area (GSHMC, 2012). Great attention needs to be taken to care for the pediatric population in a safe and responsible manner. The capital purchase of the Procedural Stretcher with IntelliDrive® Powered Transport may not add tremendous revenues but it does have the potential to save GSHMC billions of dollars by utilizing it.

The old standard trauma stretcher does not have a scale. In order to weigh the pediatric patient they would need to be placed on a separate scale. The present trauma stretcher is not utilized for transports. The current practice at GSHMC is to remove the patient from the trauma stretcher to a standard Stryker stretcher (Stryker, 2012). The standard Stryker stretchers are not practical for the transport of critically ill patients. The standard Stryker stretchers have no place to secure ventilators or halos to support airway tubing. Additionally, the standard Stryker stretcher provides only one IV pole which can only hold one IV pump.

The standard Stryker stretcher is three hundred and twenty pounds without the patient or added equipment (Stryker, 2012). Due to the weight of the stretcher and the equipment more people are needed for transports. The standard stretcher are not equipped to house ventilators, multiple pumps, suction machines, emergency airway boxes and oxygen tanks. The Procedural Stretcher with IntelliDrive® Powered Transport has ports to support plugs and offers battery power to operate life-saving equipment during transports (Krulikowski, 2012). The Procedural Stretcher with IntelliDrive® Powered Transport is covered for the life of the stretcher which is fifteen years. This coverage includes: parts, labor, yearly maintenance and replacements if needed (Krulikowski, 2012).

The Hospitals Goals

GSHMC Missions statement and goals describe the mission of the Catholic Health Services of Long Island, NY. GSHMC’s mission statement highlights caring to promote the healing process (GSHMC, 2012). GSHMC is committed to uphold the standards of the Catholic Health Services by remaining dedicated to caring for the needy and underserved (GSHMC, 2012). GSHMC’s goals include providing innovative care and treatment with compassion, justice, respect, and dignity to all patients (GSHMC, 2012). GSHMC’s primary goal is to serve all for the common good (GSHMC, 2012).

Managements Goals

The Nurse Managers at GSHMC have a tremendous responsibility to: control costs, bolster productivity, minimize expenses, and to effectively communicate. The role of Nurse Manager includes: being a team leader, role model, mentor, preceptor, advocate and a source of inspiration. The Nurse Managers uphold the visions of GSHMC and encourage their nurses to do the same. Lastly, the Nurse Managers are responsible to oversee the patient care and nursing performance on their units in order to ensure the best nursing care is being provided. Endorsing equipment that promises to help prevent dangerous drug errors, equipment mishaps, staff injury and adverse patient events must be considered as worthy investments.

Summary

The Emergency Room at Good Samaritan Hospital Medical Center (GSHMC) is one of the busiest on Long Island. GSHMC maintains the prestigious status of being a Magnet designated hospital as well as a level two trauma center (Good Samaritan Hospital Medical Center [GSHMC], 2012). GSHMC goals include providing innovative care and treatment with compassion, justice, respect, and dignity to all patients (GSHMC, 2012). GSHMC’s primary goal is to serve all for the common good of all (GSHMC, 2012). GSHMC has the only Pediatric Emergency Room in the Suffolk County area (GSHMC, 2012). The pediatric population differs from the adult population primarily because treatments and medication dosages are based on the patient’s weight (Emergency Nurses Association [ENA], 2012). The Procedural Stretcher with IntelliDrive® Powered Transport will enable pediatric trauma patients to be weighed immediately upon arrival into the trauma room.

This can avoid costly medication errors and can save over nineteen billion dollars (NCSL, 2011). The stretcher will also support and secure all of the essential life-saving equipment for transport to the Pediatric Intensive Care Unit (PICU). Back injuries and Muscular Skeletal Disorders (MSD’s) are extremely prevalent in the health care field. An estimated seven billion dollars is paid out related to the consequences of staff injuries (Menzel & Nelson, 2010). The use of the Procedural Stretcher with IntelliDrive® Powered Transport can minimize and contain costs related to: equipment damage from transport mishaps, workman’s compensation secondary to employee injury, malpractice claims related to adverse advents with poor patient outcomes (Swift, 2011).

The stakeholders are the investors, administration, management, employees, physicians, payers, vendors, and the patients served (Duke University Medical Center, 2005). The stakeholders want to see that GSHMC is investing in quality equipment or services (Duke University Medical Center, 2005). State of the art equipment that enhances patient safety and reduces expenses or prevents them actually speaks volumes to stakeholders. Stakeholders want to see that projects are aimed at improving the overall good of the hospital and not just one individual (Duke University Medical Center, 2005).

The capital purchase of the Procedural Stretcher with IntelliDrive® Powered Transport may not add incredible revenues but it does have the potential to save GSHMC billions of dollars by utilizing it. The Procedural Stretcher with IntelliDrive® Powered Transport is covered for the life of the stretcher which is fifteen years (Krulikowski, 2012). This coverage includes: parts, labor, yearly maintenance and replacements if needed (Krulikowski, 2012). Endorsing equipment that promises to help prevent dangerous drug errors, equipment mishaps, staff injury and adverse patient events must be considered as worthy investments because they can potentially save billions of dollars.

References

American Nurses Association. (2011, December 20). Nurse staffing plans & ratios. Nursing World. Retrieved from http://nursingworld.org Duke University Medical Center. (2005). Who are the stakeholders in healthcare? Retrieved from http://patientsafetyed.duhs.duke.edu Emergency Nurses Association. (2012). Weighing pediatric patients in kilograms. Retrieved from http://www.ena.org Frush, K. (2003). Study packet for the correct use of the Broselow Pediatric Emergency Tape. Retrieved from http://www.ncdhhs.gov Good Samaritan Hospital Medical Center. (2012). Good Sam. Great Choice. Retrieved from http://goodsamaritan.chsli.org Harris, J. L. (1986, May). A safe working environment for hospital nurses. AAOHN Journal, 35(5), 237-238. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com Hospitals & Health Networks. (2007, November). Improving patient flow, patient satisfaction and patient safety. Hospitals and Health Networks, 81(11), 28-29. Retrieved from http://www.ehis.ebsochost.com Krulikowski, P. (2012). Procedural Stretcher with IntelliDrive® Powered Transport. Retrieved from http://www.hill-rom.com Liebert, M. (2007, March). Caregiver injury and safe patient handling. Bariatric Nursing and Surgical Patient Care, 2(1), 7-16. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com Menzel, N. N., & Nelson, A. L. (2010, July). Special report safe patient handling. American
Nurse Today, 5(7). Retrieved from http://www.americannursetoday.com National Conference of State Legislatures. (2011). Health cost containment and efficiencies. Retrieved from http://www.ncsl.org Stryker. (2012). Stryker stretchers. Retrieved from http://www.stryker.com Swift, D. (2011, April 7). Transport of the intubated patient. Advance for Respiratory Care & Sleep Medicine. Retrieved from http://respiratory-care-sleep-medicine.advanceweb.com


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