What do YOU think President Obama should know about nursing and health care reform?

What do YOU want President Obama to know about the role of nursing in health care?

This is your chance to tell him what you think. With the ongoing discussion and debate about his proposed health care reform, there is no better time than now!

DePaul graduate nursing students are conducting a research project seeking nurses' opinions on what President Obama needs to know about nursing and how nurses can be used effectively in health care reform.

All responses are anonymous and will be analyzed and results sent to President Obama and his health care team in Washington D.C.

We encourage you to share your ideas and hope that our voice together may make a difference!

Please continue to the link posted below to share your thoughts. For any questions, please contact the researchers at depaulrn09@gmail.com.

http://www.surveymonkey.com/s.aspx?s...UeCIqaXg_3d_3d

I think he first needs to end this dreadful war that the idiot Bush got us into, then he can concentrate on health care. One promise at a time. He can also go after Bush and Cheney for war crimes and crimes against humanity.

I am not a Republican

The American College of Physicians (ACP) published a white paper Controlling Health Care Costs While Promoting the Best Possible Health Outcomeswhich needs to be looked at by reformers.

Also according to a white paper by Robert Kelley, vice president of healthcare analytics at Thomson Reuters . Over $700 billion is wasted in healthcare annually. Biggest waste groups:

Unnecessary care (40 percent of healthcare waste, or $250 billion to $325 billion).
Fraud (19 percent of healthcare waste, or $125 billion to $175 billion).
Administrative inefficiency (17 percent of healthcare waste, or $100 billion to $150 billion).
Healthcare provider errors (12 percent of healthcare waste, or $75 billion to $100 billion).
Preventable conditions (6 percent of healthcare waste, or $25 billion to $50 billion).
Lack of care coordination (6 percent of healthcare waste, or $25 billion to $50 billion).

Perhaps looking at ways to decrease this waste should be highlighted before implementing other areas of reform.

Allow RNs to spend more time providing patient care. For most RNs at least 50% of their time is spent charting/ paperwork. It is almost if a nurse's ability to provide quality patient care is judged by one's ability to document the care you wish you had time to give. Because of requirements deemed necessary by JACHO nurses are spending less time providing patient care and more time with charting. I don't know about you but I did not go to nursing school to spend my shift staring at a computer screen.

Healthcare does need reform. It is a fundamental right to be able to get care..Then maybe the ER's won't have to continue to be clinics.
As far a nursing and charting and less pt. care, not sure that will change due to jacho. Admissions take at least 45 min. if not longer to document on computer and discharges are so complicated and time consuming that the patients complain. And there ain't much we can do about it. And each year more required documentation is added to the assessment.

Interesting article at Medscape.com (you have to join, which is free and they don't spam you. Have free CEU's too).

http://www.medscape.com/viewarticle/711116

"In 2007, the Agency for Healthcare Research and Quality (AHRQ) commissioned the Minnesota Evidence Based Practice Center to conduct a meta-analysis of available nurse staffing research.[5] Investigators analyzed data from 94 studies that explored the association between nurse staffing ratios or staffing strategies and variables such as patient mortality and complications. Pooling the results from many smaller studies allowed these researchers to produce a comprehensive evidence-based report on the state of the science regarding nurse staffing and patient outcomes.

This meta-analysis concluded that higher registered nurse (RN) staffing was associated with lower rates of hospital-related mortality, mortality following a complication (failure to rescue), cardiac arrest, hospital-acquired pneumonia, and other adverse events.[5] The effect of increased RN staffing on patient safety was strong and consistent in intensive care and surgical patients. The more RN hours spent on direct patient care, the lower the risk for hospital-related death and the shorter the lengths of stay. As the number of nurse overtime hours increased, so did hospital-related mortality, healthcare-associated infections, bloodstream infections, and shock.[5]

According to the evidence report, there was a consistent and significant reduction in death rate by almost 2% for every additional nurse hour per patient. In surgical patients, every additional nurse hour per patient was significantly and consistently associated with lower rates of sepsis, failure to rescue, urinary tract infection, healthcare-associated pneumonia, surgical wound infection, pressure ulcers, shock, pulmonary failure, and deep vein thrombosis. In medical patients, an additional nurse hour per patient day was associated with reduced failure to rescue, urinary tract infection, healthcare-associated pneumonia, shock, and deep vein thrombosis. Viewed another way, Aiken and colleagues found that the risk for patient mortality and failure to rescue increased by 7% for each additional patient added to the average RN patient workload.[6]

Most current evidence suggests that a higher RN-to-patient ratio and more RN hours per patient day are associated with reduced hospital-related mortality and fewer negative patient outcomes. These observational studies do not demonstrate causality, nor are their findings sufficient to support any specific nurse-to-patient ratios.[7] Nevertheless, these findings could be used to restructure current policies related to RN numbers or skill mix in hospitals. Although studies to date largely support higher nurse-to-patient ratios, hospitals must also consider patient types, patient acuity, nurse education, care delivery models, available technology, and other factors that influence nursing workload. The authors of the evidence report also emphasize that staffing policies implemented on different patient care units must be regularly evaluated for their effectiveness.[5]"

Interesting article at Medscape.com (you have to join, which is free and they don't spam you. Have free CEU's too).

www.medscape.com/viewarticle/711116

"In 2007, the Agency for Healthcare Research and Quality (AHRQ) commissioned the Minnesota Evidence Based Practice Center to conduct a meta-analysis of available nurse staffing research.[5] Investigators analyzed data from 94 studies that explored the association between nurse staffing ratios or staffing strategies and variables such as patient mortality and complications. Pooling the results from many smaller studies allowed these researchers to produce a comprehensive evidence-based report on the state of the science regarding nurse staffing and patient outcomes.

This meta-analysis concluded that higher registered nurse (RN) staffing was associated with lower rates of hospital-related mortality, mortality following a complication (failure to rescue), cardiac arrest, hospital-acquired pneumonia, and other adverse events.[5] The effect of increased RN staffing on patient safety was strong and consistent in intensive care and surgical patients. The more RN hours spent on direct patient care, the lower the risk for hospital-related death and the shorter the lengths of stay. As the number of nurse overtime hours increased, so did hospital-related mortality, healthcare-associated infections, bloodstream infections, and shock.[5]

According to the evidence report, there was a consistent and significant reduction in death rate by almost 2% for every additional nurse hour per patient. In surgical patients, every additional nurse hour per patient was significantly and consistently associated with lower rates of sepsis, failure to rescue, urinary tract infection, healthcare-associated pneumonia, surgical wound infection, pressure ulcers, shock, pulmonary failure, and deep vein thrombosis. In medical patients, an additional nurse hour per patient day was associated with reduced failure to rescue, urinary tract infection, healthcare-associated pneumonia, shock, and deep vein thrombosis. Viewed another way, Aiken and colleagues found that the risk for patient mortality and failure to rescue increased by 7% for each additional patient added to the average RN patient workload.[6]

Most current evidence suggests that a higher RN-to-patient ratio and more RN hours per patient day are associated with reduced hospital-related mortality and fewer negative patient outcomes. These observational studies do not demonstrate causality, nor are their findings sufficient to support any specific nurse-to-patient ratios.[7] Nevertheless, these findings could be used to restructure current policies related to RN numbers or skill mix in hospitals. Although studies to date largely support higher nurse-to-patient ratios, hospitals must also consider patient types, patient acuity, nurse education, care delivery models, available technology, and other factors that influence nursing workload. The authors of the evidence report also emphasize that staffing policies implemented on different patient care units must be regularly evaluated for their effectiveness.[5]"

Teeituptom wrote:I think he first needs to end this dreadful war that the idiot Bush got us into, then he can concentrate on health care. One promise at a time. He can also go after Bush and Cheney for war crimes and crimes against humanity.

I am not a Republican

Actually the war may turn out to be a blessing in disguise. Any distraction to keep Obama and Pelosi from shoving their ridiculous reform plan down our throats is good.

Any health reform that does not address malpractice lawsuits, insurance reform and subsidizing drugs for other nations is a complete waste of time.

And crooks, er, I mean politicians on both sides of the aisle are ignoring the 600 pound gorilla in the middle of the room. Get the lawyers out of health care! If you want to protect patients from incompetent doctors, put criminal sanctions in place for legitimate negligence. The cost of health care is too high because of defensive medical practices and the billions of dollars lawyers make and take out of our health care system.:bs:

Quit and led a qualified person make the decision.


In fact, that applies to everything he decides to do, lol.

arkansasfan wrote:Quit and led a qualified person make the decision.


In fact, that applies to everything he decides to do, lol.

:yeahthat: Hate to tell ya, he didn't do a whole lot for the state of IL.
I shall leave it at that.

BiggerAl wrote:Actually the war may turn out to be a blessing in disguise. Any distraction to keep Obama and Pelosi from shoving their ridiculous reform plan down our throats is good.

Any health reform that does not address malpractice lawsuits, insurance reform and subsidizing drugs for other nations is a complete waste of time.

And crooks, er, I mean politicians on both sides of the aisle are ignoring the 600 pound gorilla in the middle of the room. Get the lawyers out of health care! If you want to protect patients from incompetent doctors, put criminal sanctions in place for legitimate negligence. The cost of health care is too high because of defensive medical practices and the billions of dollars lawyers make and take out of our health care system.:bs:

I agree with you here, too. Lawyers outnumber MD's here, which gets scary. The TV commercials seem to always pitch the 'If your kid has CP, or your loved one has fallen....call a lawyer!' line.

BiggerAl wrote:Actually the war may turn out to be a blessing in disguise. Any distraction to keep Obama and Pelosi from shoving their ridiculous reform plan down our throats is good.

Any health reform that does not address malpractice lawsuits, insurance reform and subsidizing drugs for other nations is a complete waste of time.

And crooks, er, I mean politicians on both sides of the aisle are ignoring the 600 pound gorilla in the middle of the room. Get the lawyers out of health care! If you want to protect patients from incompetent doctors, put criminal sanctions in place for legitimate negligence. The cost of health care is too high because of defensive medical practices and the billions of dollars lawyers make and take out of our health care system.:bs:

Hello out there, WAR is never a blessing in disguise, NEVER


Now you cute little flag does point out that Malpractice is a grossly over rated subject. What it totally counts for in healthcare is really just a drop in the bucket. Thats an old subject repetitively brought up to confuse issues.
Now as an old hippie I am totally in favor of subsidizing drugs, what I have to spend every month is a killer. Affects the quality of golf courses I get to play on.

Insurance companies do need reform, they have been allowed to get off completely free from any sort of regulation. They need major reform and free capitalization competition to get them to work efficiently. Insurance here in Texas for health and cars and housing is still going up as they are allegedly still paying off Katrina, if you have been to N.O. lately what are they spending their money on to repair, when it has not changed much at all.

Why distract Obama and Pelosi when The republicans have absolutely nothing to offer the American people. I mean all they could come up with is a senile old war hero, and carribou barbie. I guess they could offer that drug addict Limbaugh. He seems to be the leader of the GOP.
Obama is trying to help. The 40 million plus uninsured people out there and the people who are being ripped off by the Insurance Industry. They are trying to create jobs. They are trying to help the environment. They are trying to help decrease our reliability on foriegn oil.

If there is one area I see Obama failing in, that is in failing to bring our boys and girls home from the illegal war instituted by the illegal maneuverings of the GOP in office at that time.


Peace

Teeituptom wrote:I think he first needs to end this dreadful war that the idiot Bush got us into, then he can concentrate on health care. One promise at a time. He can also go after Bush and Cheney for war crimes and crimes against humanity.

I am not a Republican

And at the second posting this thread is already sliding downhill.

I don't think Obama, Pelosi or any of the healthcare reform gang give a rat's behind what nurses, Dr.'s or other healtcare professionals think. This is not about health care and when it's all said and done our taxes will a tripled, we'll get less health care than we do now still have over 50 million uninsured and our government will have made a permanant left of center shift that will only further erode democracy as we know it.

Also once the pay Czar gets through with the financial sector - they'll be looking for a new group to set pay limits on and I bet nurses will be one of the first on the chopping block. I can already see pay rates dropping to $15.00 or even less per hour all in the name of cutting health care costs.

Peace and Namaste

Hppy

cougarnurse wrote:And just think----this is for all those who voted for 'CHANGE'?! Hello! :nurse-soapbox:

And let's not forget hope!!!!!!!


Peace


Hppy

Teeituptom wrote:Hello out there, WAR is never a blessing in disguise, NEVER


Now you cute little flag does point out that Malpractice is a grossly over rated subject. What it totally counts for in healthcare is really just a drop in the bucket. Thats an old subject repetitively brought up to confuse issues.
Now as an old hippie I am totally in favor of subsidizing drugs, what I have to spend every month is a killer. Affects the quality of golf courses I get to play on.

Insurance companies do need reform, they have been allowed to get off completely free from any sort of regulation. They need major reform and free capitalization competition to get them to work efficiently. Insurance here in Texas for health and cars and housing is still going up as they are allegedly still paying off Katrina, if you have been to N.O. lately what are they spending their money on to repair, when it has not changed much at all.

Why distract Obama and Pelosi when The republicans have absolutely nothing to offer the American people. I mean all they could come up with is a senile old war hero, and carribou barbie. I guess they could offer that drug addict Limbaugh. He seems to be the leader of the GOP.
Obama is trying to help. The 40 million plus uninsured people out there and the people who are being ripped off by the Insurance Industry. They are trying to create jobs. They are trying to help the environment. They are trying to help decrease our reliability on foriegn oil.

If there is one area I see Obama failing in, that is in failing to bring our boys and girls home from the illegal war instituted by the illegal maneuverings of the GOP in office at that time.


Peace

First of all, I did not post that flag in my thread, I swear. I don't know how it got there. Saying Malpractice costs are a drop in the bucket is typical liberal spin. It has a huge impact. In Florida, the average OB/Gyn premium for mal insurance is over $500,000 a year. Are you gonna tell me that $ 10,000 a week in premiums is not gonna affect what he charges for his services? How many procedures that are not medically necessary are performed just to cover a doctors ass?

I was not talking about subsidizing drugs in the US. We need to stop subsidizing drugs for countries like Canada. Most of them are developed here, WE should pay less.

I know from talking to some of my liberal friends that their mindset is that we need to do something, and they are willing to accept anything. Look at how government has screwed up Medicare and the VA. Look at the failures of socialized medicine around the world. It's not gonna work. Tort reform and insurance reform is the answer. Not a 2000 page Pelosi bureaucracy.

BiggerAl wrote:First of all, I did not post that flag in my thread, I swear. I don't know how it got there. Saying Malpractice costs are a drop in the bucket is typical liberal spin. It has a huge impact. In Florida, the average OB/Gyn premium for mal insurance is over $500,000 a year. Are you gonna tell me that $ 10,000 a week in premiums is not gonna affect what he charges for his services? How many procedures that are not medically necessary are performed just to cover a doctors ass?

I was not talking about subsidizing drugs in the US. We need to stop subsidizing drugs for countries like Canada. Most of them are developed here, WE should pay less.

I know from talking to some of my liberal friends that their mindset is that we need to do something, and they are willing to accept anything. Look at how government has screwed up Medicare and the VA. Look at the failures of socialized medicine around the world. It's not gonna work. Tort reform and insurance reform is the answer. Not a 2000 page Pelosi bureaucracy.

Outrageously rising premiums this past decade, Hmmm while the Republicans were in office, Obama has been in office less than a year. Also, and you can find proof here in Texas also. Rising premiums on malpractice, housing, auto, and health are being used by the insurance companies to line their pockets after their losses from Katrina and other natural disasters. I got this information straight from the State Insurance Agency.

As far as medicare and the VA. They didnt get screwed up over night, The Republicans have been trying to do that to Medicare for decades now. Trying to get medicare money to finance their illegal war. And the VA has deteriorated since Nam and the Agent Orange Fiasco. You cant blame that on Obama. The Republicans and their Military, Oil Industrial Complex. are to blame there.

I know there are supporters of the G.O.P. here that is fine. I would like to see what the leadership of the GOP has to say also. But when you see that the current best leadership of the GOP is Sarah Palin and Glenn Beck. I would support a Ticket led by Palin and Beck. They could call it the End of Humanity Ticket. Her ineptitude and his hatred is a winning combination for sure. Both have come out against education and medical care for all. Imagine how much good they could do for nursing.

Hmmm.......let's be fair here: Obama was ELECTED to serve Illinois, also, yet he was 'on the road' more than he served the state. Since when did voting 'present' (when he wasn't...) count?
[B]

I believe LBJ was in office when the Medicare bit all started, and FDR started SSI. Just had an interesting conversation with my mom on this, as our family was nominally Dem. until FDR's 3rd election. Oh, and 'Nam actually has ties to the WW2 era.

Mind you, this is a bit off subject, so.... :p
[/B]

So why is your mood GRUMPY
While my mood is AMUSED

While talking about Obama there and his voting.

Reminds me of GW and his alleged service during Nam, where he maneuvered everything so he would not be sent over.

However the public option needs to be discarded as it is so watered down now anyway. Focus on reforming the Insurance Industry nightmare.


Focus on jobs for the infrastructure

Focus on building new Green business and technologies


Lets Go Green

BiggerAl wrote:First of all, I did not post that flag in my thread, I swear. I don't know how it got there. Saying Malpractice costs are a drop in the bucket is typical liberal spin. It has a huge impact. In Florida, the average OB/Gyn premium for mal insurance is over $500,000 a year. Are you gonna tell me that $ 10,000 a week in premiums is not gonna affect what he charges for his services? How many procedures that are not medically necessary are performed just to cover a doctors ass?

I was not talking about subsidizing drugs in the US. We need to stop subsidizing drugs for countries like Canada. Most of them are developed here, WE should pay less.

I know from talking to some of my liberal friends that their mindset is that we need to do something, and they are willing to accept anything. Look at how government has screwed up Medicare and the VA. Look at the failures of socialized medicine around the world. It's not gonna work. Tort reform and insurance reform is the answer. Not a 2000 page Pelosi bureaucracy.

Actually the VA is a good anology on doing more with less and is not the what shown in the movie "Born on the Fourth of July". The VA is head of most private companies. The VA has been a leader in primary care, EMR development and tele-medicine. All of which have been shown to reduce costs.

The real cost of malpractice is the costs of defensive medicine which causes physicans to overtreat patients in order to prevent lawsuits. Here's a link to a great article on this:

http://www.medscape.com/viewarticle/711110_2

There a book out call Overtreated that I also highly recommend that covers a number of issues. The main one being the FFS healthcare system that rewards physicans doing procedures and not with outcomes. Dr. David Eddy (MD. PhD) is at the forefront these and other issues. I highly recommed reading up on what he has to say.

While I would like to see healthcare reform I think that all the government is going to do is to cover more people with out addressing the underlying cost issues that are driving up healthcare. I worked for the fourth best HMO in the US according to US News and World Report for the past seven years I can tell you we are bleeding money, and have less then half the membership then when I started there in 2002. As Dr. Eddy said, Americans want a $40,000 car for $20,000 and get a $25-30,000 car. In this anology, American want a high value health system but only want to pay half the value, and only get a health system that is slighly better than what they pay for.