Biomedical subjects

Darlene Bradley

Publications and source records attributed to Darlene Bradley.

3 recordsLinked to original sources

PubMed2005

Observation medicine: the expanded role of the nurse practitioner in a pediatric emergency department extended care unit.

BACKGROUND: The use of observational units (OUs) in pediatric emergency departments (EDs) has become an important adjunct to emergency care. An extended observation period (4 to 23 hours) in the ED has decreased both the number of admissions and prolonged use of acute ED beds. This serves to increase patient satisfaction as well as optimizing care. The use of OUs allows for the most appropriate allocation of resources. These units are typically located within the ED or immediately adjacent to it. The ED physicians are the gatekeepers of the unit and serve as the medical supervision for these patients. The Children's Hospital of Philadelphia developed an OU known in the hospital as the Emergency Department Extended Care Unit (EDECU) approximately 5 years ago. In order for the EDECU to function at its fullest potential, the ED at The Children's Hospital of Philadelphia has opted to use the ED nurse practitioners (NPs) to enhance the care for these patients. OBJECTIVE: The NP has been an integral member of the ED for the past 10 years with primary roles in urgent care and in the follow-up program. As the ED expanded to include the EDECU, the role of the NP also developed to meet the needs of these patients. A review of the role development of the ED NP in observation medicine and the impact on patient and staff satisfaction as well as contributing to fiscally responsible care will be addressed. METHODS: A retrospective review of the NP's role development in the evolution of the EDEDU. RESULTS: Incorporation of the NP in the treatment team has provided efficient use of professional staff, comprehensive patient care, and increased patient satisfaction. CONCLUSIONS: The use of the EDECU has become an important part of the services offered in the ED at The Children's Hospital of Philadelphia. The integration of the NP in a pivotal role allows for optimal use of human resources, and provides efficient, cost-effective patient care in the ED.

Child↗

PubMed2004

HIPAA compliance efforts.

OBJECTIVES: Identify the regulations from the Health Insurance Portability and Accountability Act (HIPAA) that impact the emergency department. Describe processes that demonstrate compliance with the security and privacy regulations that pertain to protected health information. Identify the consequences of noncompliance to this congressional mandate. METHODS: A review of the literature was conducted to extract the effects of the legislation on emergency services. Since the inception of the law in 1996, additional regulatory requirements have been added to the protection of protected health information. Concomitantly, practice changes are conducive to emergency department's compliance with these regulatory mandates. RESULTS: HIPPA encompasses 6 components in the regulations that must be addressed. Of these, most organizations focus on the greatest areas of risk, which include the transmission of electronic data and the security and privacy components. To avoid financial penalties and imprisonment, facilities must demonstrate and adhere to the regulations outlined. Verification of compliance could occur through random unannounced visits by the Department of Health and Human Services, Office of Civil Rights, or through health information privacy complaints filed against the individual or the organization. CONCLUSIONS: A sharing of best practices and benchmarking could contribute to organizational savings and improve productivity if facilities were forthcoming in describing how they demonstrate compliance. As interpretations and applications of the law are modified, practice changes will also occur. Since each facility is held to the same standard, it behooves one to provide mutual support so as not to begin the process from its genesis.

Confidentiality↗

PubMed2003

Perspectives on newborn abandonment.

OBJECTIVES: The goals of this study were to identify the socioeconomic influences that may lead to newborn abandonment and the attributes common to individuals who abandon their infants, to develop an understanding of the legislative issues affecting the abandonment of newborns by state, and to describe an emergency care program designed to preserve newborn life. METHODS: A retrospective review of case files, publications, and headline news was undertaken to identify commonalties among individuals who abandon their infants. Accurate statistical data about this issue are nonexistent; however, extrapolations can be made from documented cases. Predictors of abandonment assist healthcare workers in identifying and preventing the needless deaths of newborn infants through early education and prevention programs. If these children survive, they often become the challenges of emergency care staff. RESULTS: There are now at least 46 states that have proposed or enacted legislation related to infant abandonment. The laws are designed to promote the safe surrender of newborns to designated child protective agencies, including emergency departments. These legislative controls now regulate safe havens to accept newborns that would otherwise be abandoned. CONCLUSIONS: There is still much to learn about infant abandonment. A national database to compile statistics about the incidence of abandonment is currently not available. Research is necessary to validate the findings collected in retrospective reviews. The choices parents make between the options of abandoning versus surrendering the infant to a safe haven require further study. Preventative programs and education of the public and particularly of the high-risk groups require a greater emphasis on improving child protection procedures. Programs in emergency departments must be developed to expedite care and to support and protect life.

Adult↗