In 1981 reimbursement was based on fee for service therefore 24 to 28 team
members were paid for by rote chargeable tasks in the form of tubings, dressing
kits, multiple peripheral IV's etc
Reimbursement for the 2000's is based on performance improvement not rote
tasks. Whether we like it or not hospitals are now a business and the key
component to today's IV therapy is reliable access allowing bedsides nurses to
plug and chug medications and get the patient out the door. That is reality.
In 2000 nurses are taking over central line placements. That is a good thing.
I don't want the good old days back as when I was an ICU cardiac bypass nurse
my patients were in house for six weeks. Intubated for three days. Not
allowed to get out of bed for one week. In house cardiac rehab for three
weeks. Pneumonia, DVT, Strokes were my friends. Patients died. DRG's made us
change this system but change is good. Patient survival is higher after the
change.
kathy
________________________________
From: [EMAIL PROTECTED] on behalf of Lynn Hadaway
Sent: Wed 2/8/2006 5:17 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Re: PICC infections
That is exactly what I am saying. The IV team did every IV task, procedure,
assessment, etc on every patient on the med-surg units, OB, ortho/neuro, etc up
to and including charting the fluid intake from all IV procedures.. We covered
the ICUs, peds and ER when called to help with a difficult stick or to place
PICCs. I can not remember our exact # of FTEs but it was around 24 to 28 for a
~300 bed community hospital. We were on the cutting edge of everything -
placing PICCs in 1981, managing PCAs, epidurals, before they were commonplace.
The structure of this team changed in the late 1990s when all the teams were
cut out or cut back. Fortunately this team was only cut back and restructured.
This hospital still has a team of about 12 to 14 FTEs though. Lynn
At 6:48 PM -0500 2/8/06, [EMAIL PROTECTED] wrote:
are you saying that your IV team did every IV medication? hourly pain
meds, as well as all the K supplements, TPN, and everything??? how many nurses
were employed on that IV team and what was your total census? i cannot imagine
covering a 550 inpatient tertiary care center and handling every IV medication.
did you also draw all the bloods and change all the dressings? and manage to
get PICCs inserted too? i agree that too many hands in the PICC action
increases the risks of infection, but i also know that there is no way my
partner and myself can handle everything that you managed to do. we have to
keep our head above water just to get the lines inserted. would i love a
vascular access team? absolutely! is that a reality in the near future?
probably not. it is a long process. my focus right now is education!!!!
proper care and management of the lines until the time that a vascular access
team is a reality. and if i can educate one nurse at a time, i am happy.!
we are working to get a team in place, but budget constraints are always an
issue. for the time being, we are educating, educating and educating.
Vascular Access Clinician
Albany Medical Center Hospital
New Scotland Ave.
Albany, New York 12208
[EMAIL PROTECTED]
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
