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As part of its Outpatient Prospective Payment System (OPPS) payment rule for 2009, the Centers for Medicare & Medicaid Services (CMS) has established a multiple imaging composite methodology, which means it will provide a single composite ambulatory payment classification (APC) payment each time a hospital bills more than one procedure from an imaging "family" on a single date of service. The families are:
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If someone told you that an ED had experienced a 60% increase in volume between 2000 and 2008, you wouldn't be surprised to learn that the average length of stay (LOS) for their patients also had increased dramatically.
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Decreased renal and hepatic blood flow. Decreased glomerular filtration rate. Decreased total body water. Increased percentage of body fat.
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"This is one of my favorite problems to 'diagnose,'" says Joan Somes, PhD, MSN, RN, CEN, FAEN, ED educator at St. Joseph's Hospital in St. Paul, MN.
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Psychiatric patients can leave your ED without warning or cause harm to themselves or someone else, says Nancy Bennett, RN, MSN, ED educator at The Hospital of Central Connecticut in New Britain.
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If a psychiatric patient came to your ED acting aggressively with pressured speech, you might conclude that the behavior was caused by failure to take antipsychotic medications.
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When a Swiss tourist came to a Tucson, AZ, ED with pneumonia, none of the ED nurses suspected that measles was the underlying cause. As a result, the patient wasn't isolated, and patients and health care workers in the ED were needlessly exposed.
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Here are assessment tips to use at triage if you suspect that your patient might have deep venous thrombosis (DVT):
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The middle-aged man on medication for erectile dysfunction who is given beta-blockers for chest pain. The diabetic patient on glucophage who gets a CT scan with contrast.
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A child who was involuntarily committed managed to walk out of the ED at All Children's Hospital in St. Petersburg, FL, right past a security guard and out the main hospital doors.
