A Hospital is a healthcare institution providing patient treatment with specialized medical and nursing staff and medical equipment. The best-known type of hospital is the General hospital, which typically has an emergency department to treat urgent health problems ranging from fire and accident victims to a heart attack. A District hospital typically is the major health care facility in its region, with large numbers of beds for intensive care and additional beds for patients who need long-term care. Specialised hospitals include trauma centers, rehabilitation , children’s hospitals , seniors’ (geriatric) hospitals, and hospitals for dealing with specific medical needs such as psychiatric treatment (see psychiatric hospital) and certain disease categories. The medical facility smaller than a hospital is generally called a Clinic and at last a Teaching hospital combines assistance to people with teaching to medical students and nurses.
How to Find a Good Hospital
WHEN IN NEED OF MEDICAL care, picking a good hospital is one of the most important choices a savvy consumer can make. And while patients with especially complex cases or rare conditions may need to get care at one of World’s Best Hospitals. Relatively few of the 1.2 billion people admitted to a hospital annually do much in the way of comparison shopping among their local medical centres. Nearly 60 percent of people say they would choose a hospital based on familiarity, whereas only 35 percent would seek out a higher-rated facility. The reality is that not all hospitals or doctors or nurses, for that matter deliver high-quality care. Even the type of treatment that similar patients get can vary from hospital to hospital and region to region. In some parts of the country, for example, heart patients are more likely to receive angioplasty than coronary bypass surgery, while in many places the opposite is true.
The good news is that the “inconsistency [in care] is not a mystery.” By tapping a few readily available resources, patients can make informed and empowering decisions about a good local hospital for the treatment they need.
Any of the following resources could help you make an informed decision if you, a family member, or a friend need to visit a hospital. Using several of these resources is even better than relying on just one. So roll up your shirt sleeves and do your research as if your life depends on it:-
:- Your primary-care physician. Consult this trusted source if a specialist ever tells you that surgery or treatment is necessary, and ask your primary-care doc where he/she recommends you have it done. Primary-care physicians have a good working knowledge of the hospitals in the area, including each institution’s overall reputation and how it stacks up against its local peers for specific procedures and treatments.
:- Your insurance company. Inquire about the quality data they’ve collected on each facility where they would cover your treatment. Most health plans have some information available about the quality of care delivered by different providers. That info can typically be found on the plan’s website or by phone. The data might be limited to the pool of patients plan covers and the doctors and hospitals in the plan’s network, but it’s nevertheless a source of details that can inform your choice.
:- That friend of a friend who is a nurse. Hospitals are the nation’s second-largest private-sector employer, according to the Hospital Association, so your extended social network may include more hospital employees than you realize. Most people know someone in the local healthcare system. Find that person and chat them up. But realize they provide a narrow view, seeing perhaps only one slice of all the variables that make up a hospital’s level of care.
:- A trusted family member or friend. Bringing someone you trust to an important appointment, or simply going through the hospital-selection process with another person, can be quite powerful. If nothing else, your companion is likely to be more clear-headed than you are when you’re faced with daunting new information about your health. He or she need not be a medical professional.:-
:- Highway billboards touting a hospital’s latest award. They’re hard to miss—and plentiful in many regions of the country. But beware the source. Before you let that billboard or full-page newspaper ad sway your decision, “Can you find information on how [the group giving the award] defines good quality?” The prize may or may not have any real bearing on the quality of care a patient could expect at that hospital.
Who Are Hospital Staffs And Their Roles
The consultant is the most senior doctor in charge of a patient’s care. Unlike other doctors they don’t wear a doctor’s coat so it’s easy to identify them. They are responsible for overseeing diagnosis, care and treatment so lead a team of more junior doctors including registrars. A consultant is always a specialist.
Dieticians are trained in the science of nutrition which they use as a basis to provide practical information about food. Their role is therefore focused on the assessment, diagnosis and treatment of diet and nutrition related health issues. They do not wear a nurses uniform. Dieticians can work in hospital or community settings.
Physician’s Assistant (Associate)
This role is primarily a technical one providing clinical support to doctors and nurses by undertaking specific clinical tasks. The role can be called physicians associate or assistant. Physicians’ assistants typically wear scrubs either in the same or a different colour to other medical staff. Their main responsibilities include taking patient histories, analysing test results, and performing examinations. They operate under the supervision of a doctor.
Charge Nurse (Ward Sister)
This role is a clinical management one and deputies for the senior sister. Male and female charge nurses typically wear color coded tunics and trousers. Their tunics have epaulets. This role has budget and quality improvement responsibilities but is still involved in assessing patients and implementing evidence based care. They are also responsible for the safety of the clinical environment.
Housekeepers coordinate catering, cleaning and maintain equipment. This means they work with other staff to ensure patients have the correct food and that their bed area is tidy and clean. Typically housekeepers were dark trousers and a tunic with a shirt collar which distinguishes them from nursing staff. Housekeepers may also coordinate additional services including laundry.
This is a senior nursing role overseeing a number of wards that form a division. Typically these nurses wear a matching tunic and trousers typically in colour such as navy blue/blue. Has responsibility for troubleshooting problems that more junior nursing staff can’t deal with. Part of their role is to work with divisional management including a general manager and senior clinical staff.
Healthcare Support Worker
This role supports staff nurses and is sometimes called a nursing assistant. Typically female healthcare support workers wear self-coloured dresses and their male counterparts were self-coloured tunics. Typical tunic or dress colours are white or light blue. Duties may include washing and dressing, bed making and serving meals.
This role has responsibility for ensuring wards are clean and tidy. Typically domestic assistants wear dark trousers and a contrasting tunic. This role may wear the same uniform as a housekeeper. Domestic assistants are required to clean to a high standard.
An occupational therapist (OP) uses activity to help patients function independently. Disability can be caused by aging, accidents, psychological or physical illness. Occupational therapists wear comfortable clothing – typically a polo shirt and trousers. The nature of their work requires freedom of movement. OPs can work in hospital or community based settings.
Physiotherapists treat patients who have mobility issues. Typically they wear tunics or polo shirts partnered with trousers. In hospitals therapists are attached to most, if not all, wards. They have a particular role to play in ICU settings. Whether patients’ physical problems are caused by aging, illness or accidents, it is the physiotherapists’ role to assist wellbeing through movement.
Senior Clinical Nurse
This role is the senior nurse in charge of a group of wards. Their uniform can be similar to a Divisional Nurse’s and can be a tunic and trousers or a dress. The colour of their uniform /style of dress or tunic will distinguish them from other nurses so is frequently a darker colour with piping. This role has particular responsibility for the clinical care of patients throughout a number of wards.
Senior Sister (Charge Nurse)
The senior sister has responsibility for managing a whole ward and is charged with improving outcomes and experiences for patients, families and carers. They typically have a responsibility for staffing and ensuring all patients are assessed so professional leadership and line management are integral to the role. The precise responsibilities vary across Trusts. They typically wear a dress or tunic and trousers. Depending on policy, coloured piping may identify the role.
A nurse operating within a distinct medical specialisation typically ward based working with patients who have long term conditions including stroke, dementia, diabetes, chronic heart failure and cancer. A significant part of their role is helping patients manage their symptoms. Male nurses wear a tunic and trousers and female nurses wear the same although typically a different coloured tunic. Female nurses may also have the option of wearing a dress depending on Trust policy.
Staff nurses are responsible for the nursing care patients receive and typically work in teams. They typically wear light coloured dresses or tunics and trousers. As well as having responsibility for patient care they will also have audit and quality responsibilities. Staff nurses facilitate the learning of less experienced staff.
Student nurses are typically found in teaching hospitals and can either be completing a degree or be an LPN candidate. Student nurses roles vary but the main element is to assist more senior nurses and learning to complete a range of medical procedures to an acceptable standard. They must also develop an understanding of nursing policies. Student nurses’ uniforms tend to be light coloured tunics and black or navy trousers.
Ward clerks fulfil an administrative role. If in uniform they were tunics or shirts and trousers. Clerks have a wide range of responsibilities including booking patients for appointments, filing and keeping patient records. Clerks also handle general enquiries from patients and family members whether face to face or over the phone. Ward clerks have responsibility for admissions to their ward.
Hospitals are moving away from traditional, clinically oriented design in favor of an environment that is more comforting and familiar to patients.It’s all based on the idea that the perfect hospital environment can not only promote rest and healing, but can also aid in preventing patient falls, hospital-acquired infections, and certain kinds of medical errors. For an idea of how this all comes into play, take a look at this info graphic from the Wall Street Journal, depicting The Hospital Room of the Future.
Patient-centric design often highlights the role of nurses as frontline caregivers and streamlines interactions between the nurse, patient, and family members. An example is nursing work stations that are strategically located at the entrance to patient rooms, instead of in a centralized location farther away from patients.
A dynamic environment can also emphasize best practices in infection control – for example, by placing sinks and sanitizer stations at the point of use, and using a visual reminder like a light to prompt clinicians to practice good hand hygiene. According to an article in Health Care Design magazine, furnishings can also have a big impact on hospital-acquired infections. In patient-centric and evidence-based design, furniture and surfaces are easy to clean and disinfect. They feature rounded corners, non-textured surfaces, and clean lines that offer pathogens and dust fewer places to hide. Likewise, furnishings can be designed to minimize the likelihood of falls.
A recent article explored the trend of luxury amenities in hospital rooms – high-ticket items that might include private rooms, plush couches, or organic food by a celebrity chef. It included a rather controversial quote by a health economist who believes the demand for a hospital correlates more to its hospitality services than to quality of care. Of course, this point of view is the antithesis of nursing philosophy. The focus of nursing care remains on the health outcomes of the patient, the use of evidence-based practice standards to assure safe and effective patient care, and the provision of an environment conducive to rest and healing.
Yet, there may be good ways to apply the concept of hospitality to health care – by reducing environmental stressors, for example. This is where evidence-based design comes into play: research has shown that sleep is important to both mental and physical health. Patients face an enormous number of disturbances every day and noise is a common source of patient dissatisfaction. Since hospitals are now being ranked on patient satisfaction scores through the HCAHPS survey, there’s a new emphasis on using technology to reduce extraneous noise, for example by replacing overhead paging systems with a nurse call system that routes a request to a mobile phone. Patient monitoring devices can also be designed to send an alert to a specific individual, rather than beeping and clanging in a patient room.
Patient Safety In Hospital
Patient safety practices have been defined as “those that reduce the risk of adverse events related to exposure to medical care across a range of diagnoses or conditions. This definition is concrete but quite incomplete, because so many practices have not been well studied with respect to their effectiveness in preventing or ameliorating harm. Practices considered to have sufficient evidence to include in the category of patient safety practices are as follows:
Many patient safety practices, such as use of simulators, bar coding, computerized physician order entry, and crew resource management, have been considered as possible strategies to avoid patient safety errors and improve health care processes; research has been exploring these areas, but their remains innumerable opportunities for further research. Review of evidence to date critical for the practice of nursing can be found in later chapters of this Handbook.
The origins of the patient safety problem are classified in terms of type (error), communication (failures between patient or patient proxy and practitioners, practitioner and nonmedical staff, or among practitioners), patient management (improper delegation, failure in tracking, wrong referral, or wrong use of resources), and clinical performance (before, during, and after intervention).
Nursing As the Key to Improving Through Patient Safety. Further, when we consider the key role of communication or communication lapses in the commission of error, the role of nursing as a prime communication link in all health care settings becomes evident.
Safety Measures in Hospital
Bed controls and safety
Ask your nurse how to use the bed controls. Never try to lower the bed’s side rails or climb over them. Keep your top two side rails up at all times. Ask for help to get out of bed and wear slippers or shoes with non-skid soles. Never use a bedside table or over bed stand for support; they may move. Be very careful in the bathroom; move slowly and use the grab bar. Don’t hesitate to call for help. Falls are the most common source of patient injuries, especially falls from or near the bed. Your physician will order activity based on your condition. Please check with your nurse before getting out of bed or sitting. Use your nurse call button to get help.
Dentures and Eyeglasses
Dentures and eyeglasses should be stored in the drawer of your bedside table. You are responsible for any personal items you bring to the hospital.
Don’t become overly concerned when you hear the sound of a fire drill alarm. Stay where you are unless instructed otherwise by hospital personnel. Fire drills are routinely conducted on all three shifts.
Mon General is a non-smoking facility. Visitors and patients are not permitted to smoke or use tobacco products within the hospital or on hospital grounds.
Personal electronic appliances
Hospital safety regulations prohibit the use of your own television or video games in the hospital. Hospital personnel must perform electrical safety tests on any appliances you bring from home before you use them at Mon General. Please ask your nurse to call Facilities Management to check your personal appliances.
Prescription drugs and herbal supplements
If you were taking prescription drugs before your hospitalization and brought them with you, please show them to your nurse so he/she can record the information, and tell the doctor about your current prescriptions. Send your medications home with your family or friends after the nurse has reviewed them with you. Your physician will order the medications you need in the hospital, and our staff will give them to you.
If you have been taking any herbal products or dietary supplements, they may interact with medications your doctor may prescribe while you are in the hospital and when you go home. Let your physician and nurse know of any products you were taking at home.