Information that is important to nurses

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Here are excerpts from three articles about issues affecting nursing today.  HIPAA is a biggie!  Here is an article about what happens when you don’t follow the HIPAA regulations; violence in both the workplace and in the community affects nurses daily.  Hospitals are historically located in low-income areas and crime is usually higher in and around those areas.  Hospitals treat trauma and have drugs.  Nurses work strange hours and come and go to cars parked in not-to-secure places.  Violence toward healthcare workers is also on the rise and prevents some nurses from giving adequate care because they are afraid of assault.

Please read these articles at the source and let me know what you think we can do about these issues, won’t you?

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Houston hospital workers fired for HIPAA violations

By Associated Press

Posted: November 26, 2009 – 1:30 pm EDT

Sixteen employees have been fired from the Harris County Hospital District in Houston, Texas, for alleged violations of patient privacy laws involving the records of a first-year resident, according to a district official.

The Houston Chronicle reports that the workers were fired late last week for looking at the medical records of a first-year Baylor College resident assigned to Ben Taub General Hospital. The doctor, Stephanie Wuest, became a patient at the hospital on Oct. 29, after she was shot in a grocery store parking lot. Her mother says she’s expected to recover.>>>read more

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The cost of murder Anti-violence groups, hospitals work to try and stop homicides, which have negative impacts on both the community and bottom lines

By Joe Carlson

Posted: November 30, 2009 – 5:59 am EDT

Jason was 8 years old the first time he came to the emergency department at 236-bed Children’s Hospital of Wisconsin in Milwaukee with alarming injuries, the results of being severely beaten on the playground.

Four years later, he returned to the ER with multiple stab wounds from scissors reportedly plunged into him by a classmate. The same nurse who cared for Jason the first time took care of him again, now concerned for his safety but powerless to do anything.

The last time Jason came to Children’s, he bypassed the emergency room and went directly to trauma, where surgeons tried to repair the damage of a gunshot wound to the chest. He was 16 years old, and he never left the hospital. For the third time in eight years, the same nurse was at his side and trying to reconcile her conscience as she tended to him on his deathbed.

“The nurse was saying, we have to do something for these kids. We’re just treating their wounds and not figuring out what is causing them and having them come back to us,” said Toni Rivera, recounting the story of the nurse, Jennifer Wincek, and the young patient, whose name was changed to protect his family’s identity. Rivera is today the manager of Project Ujima, one of the longest-running hospital-based violence prevention programs in the country.

Through education and community-outreach activities, Rivera said the program has decreased emergency-room recidivism—repeat trips to the ER within a year’s time—from the 18% seen in 1995 to 1% today among the 300 kids who take part in the program annually.

In 2009, 14 years after Project Ujima formed, it remains the only such program in Wisconsin. Officials with the Chicago-based organization CeaseFire, which partners with hospitals to help break the cycle of retaliatory street violence, estimates that 80 metropolitan areas are ripe for such programs judging by their per-capita rates of intentional violent injury.

“The hospital is absolutely a key partner in preventing violence,” said Sheila Regan, hospital response program specialist for CeaseFire. “On a daily basis, the hospital is a central partner.”

Proponents of the programs say many administrators whose trauma centers record high rates of violent intentional injuries are missing a crucial chance to save more lives and prevent costly admissions and readmissions. Although such programs can be expensive and operationally complex, all are based on the idea that the most efficient way to locate people most likely to be involved in the next violent incident is to meet them at the hospital in the aftermath of the latest trauma.

Supporters often compare the state of such programs to domestic-violence prevention programs in the 1970s. Just as it would be virtually unthinkable today to discharge a battered wife into an abusive home without offering help, proponents of community-violence prevention programs are hoping for the same kind of widespread acceptance of their ideas in hospitals someday. Although some evidence shows that community-violence programs save lives and cut healthcare and government costs, many of the existing projects are at risk of losing funding while money remains a major hurdle for prospective initiatives.

All such programs are founded on the belief that hospitals ought to be doing more for community violence victims than sewing up their wounds and handing them the phone number of some community agency. This new approach is known as the public health response, and employs epidemiological principals in the prevention of community violence.

“It’s very frustrating to you as a surgeon to see someone who you’ve spent three, four, five hours in their abdomen putting together their bowels … and then a year later, you see them come back to the hospital, this time for a gunshot wound to the head,” said Carnell Cooper, associate professor of surgery at 666-bed University of Maryland Medical Center in Baltimore, and executive director of the Violence Intervention Program in the hospital’s R. Adams Crowley Shock Trauma Center.

Anti-violence programs have been executed widely in large and small communities alike for decades, but the more recent idea of involving hospitals in the formula is based on three concepts. The first is that the most accurate predictor of a violent injury is if one person has already been violently injured, so that hospitals are seen as collection points for people who know where the next incident is going to happen, including not just victims but their families and friends. >>>read more

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Anti-violent beginnings Hospital-based programs among the options

By Joe Carlson

Posted: November 30, 2009 – 5:59 am EDT

The impetus to launch a hospital-based anti-violence program usually doesn’t come from CEOs concerned about their local communities or from an overworked social worker on the hospital staff.

In most cases, experts say, it starts with a trauma surgeon who is fed up with repeat trauma visits and sees that social norms in violent communities are essentially undermining the advances in medical science by returning ever-more victims for all those whose lives are saved on the operating table.

“I think the time is right for us to get even more involved as a profession,” said Robert Barraco, associate director of trauma at Lehigh Valley Hospital in Allentown, Pa., and chairman of the Injury Control & Violence Prevention Committee of the Eastern Association for the Surgery of Trauma. “We certainly have an ethical responsibility to participate in prevention efforts through our trauma services, and I look forward to more and more of these programs popping up across the country and becoming successful and producing more data.”

But violence prevention programs tend to be labor-intensive and difficult to classify in a hospital’s organizational chart. When deciding to start such a program, one of the earliest decisions to make is whether to implement a program that is hospital-based or hospital-linked.

In the former category, the caseworkers who make first contact with the victims receive paychecks from the hospitals and are part of the medical staff. One major advantage of this approach, observers say, is that employees don’t have to worry about violating the privacy rules in the Health Insurance Portability and Accountability Act of 1996. Hospital workers can walk around freely inside the facilities and don’t have to worry about getting consent forms signed before reviewing medical charts or talking with patients.

However, hospital employees may work regular business hours and can’t respond immediately during peak trauma times. Research from CeaseFire, an organization committed to reducing shootings and killing, shows that the most common time its workers respond to a violence victim is 2 a.m., and the most common day is Sunday.>>>read more

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