Patient Care Team

Teamwork

-Ability to work towards a COMMON VISION -Ability to direct individual accomplishments toward organizational objectives

Patient Care Team

-All of the various health care professionals and hospital personnel that directly or indirectly participate in patient care -Patients are the final decision makers for the patient care team 1. ALLIED HEALTH 2. PHYSICIAN 3. NURSES 4. PATIENT 5. VOLUNTEER

Licensed Vocational Nurse (LVN)

-Assist in patient care under the SUPERVISION of RN and physician -Basic bedside care, vital signs, change dressings, administer injections, monitor equipment and update charts -Helps keep patients comfortable, assist with bathing, dressing, and personal hygiene -May supervise CNAs

CCE Scope of Practice- Responsibilities

-Assist the nurse in transport, repositioning, or toileting tasks -Assist the unit secretary with paperwork, telephones, or call lights -Assist hospital staff and physicians as required -Assist the patient and family

Physician Extenders

-Carry out certain duties typically associated with physician (usu. PA or NP) -Incr. demand due to Dr shortage -Incr access to medical care -Incr patient satisfaction, decr wait times -More time to educate and counsel patients -Improve EFFICIENCY & FLOW -Assist with reviewing and signing labs -Can aid in signing medical charts and prescribing drugs -Lessen burden on physicians

Registered Nurse (RN)

-DIAGNOSE & TREAT wide range of acute chronic illnesses and injuries -Interpret lab results -COUNSEL patients -Development TX PLANS -May PRESCRIBE MEDS -May practice INDEPENDENTLY

Scope of Practice

-Defines the duties or services that a particular health care practitioner is AUTHORIZED to perform -Limits are based on education, clinical experience, and verification of competency -Professional license, registration, or certification required for each occupation with a defined scope of practice -Some professionals are authorized to practice independently within their scope -Some are required to work under supervision of physician or in collaboration with a physician or other health care practitioner

Physicians

-Diagnose illnesses and prescribe and administer treatment for people suffering from injury or disease -Examine patients, obtain medical histories, perform procedures, and order and interpret diagnostic tests Two types: MD (allopathic) practice conventional medical therapies; DO (osteophatic) trained in OSTEOPATHIC MANIPULATIVE MEDICINE (OMM): a holistic philosophy with emphasis on musculoskeletal system

Pharmacist

-Dispenses prescription medications to patients -Advises drs and patients on drug uses, side effects, interactions and dosages

Popular Culture Influences

-Doctor centric -Contributions of other health care staff are marginalized -Nurses and allied health professionals are frequently absent -Emphasis on spectacular, once-in-a-lifetime situations rather than day to day occurrences

Clinical Laboratory Scientist (CLS)

-Duties overlap with that of CLTs but perform MORE ADVANCED TESTING -Conduct molecular diagnostics and highly involved microbiological and cross-matching blood tests -Evaluate and interpret lab results, integrate data, solve problems, consult with physicians, conduct research, and develop new test methods

Emergency Medical Technicians (EMT) & Paramedics

-EMERGENCY RESPONDERS trained to provide emergency medical services -Work is physically strenuous and can be stressful -Involves LIFE OR DEATH situations and suffering patients -Respond to various cases: automobile accidents, heart attacks, drowning incidents, childbirth, gunshot wounds

Requirements for a Functional team

-Effective communication -Patient centered focus -Common goal -Understanding roles -Confidence in team members

Respiratory Therapist (RT)

-Evaluate, treat, and care for patients with BREATHING DISORDERS -Test the capacity of patients' lungs and analyze O2 and CO2 concentrations -Operate O2 tents, incubators, iron lungs, mechanical ventilators, O2 tanks -Help patients with breathing exercises

Dentist

-Examine, diagnose, and treat patients that have problems with their teeth and gums -Design and implement tx plans to help patients restore and maintain optimal oral health

Optometrist

-Examine, diagnose, treat and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures -Identify systemic conditions affecting the eye -Prescribe medications, provide vision therapy, and prescribe and dispense eyeglasses and contact lenses -Provide pre- and post-operative care to those undergoing cataract and other eye surgeries

History of Allied Health

-Explosion of scientific knowledge following WWII -Increasingly sophisticated and complex diagnostic and treatment procedures -Incr need for many specialized and expertly trained health care delivery personnel -Physicians and nurses need more help with incr demands of patients

Physical Therapist (PT)

-Help RESTORE function, IMPROVE mobility, RELIEVE pain, PREVENT permanent physical disabilities -Examine medical histories and test patients' strength, range of motion, balance, and muscle performance -Determine ability to reintegrate into community &/or workplace after injury

Occupational Therapist (OT)

-Help people to develop, recover, or maintain DAILY LIVING/WORK SKILLS -Help patients with mentally, physically, developmentally or emotionally disabling conditions -Help improve basic motor function and reasoning ability -Help clients have INDEPENDENT, productive, and satisfying lives

Obstacles to a Successful Team

-Ineffective leadership -Lack of understanding -"Turfism" -Financial structures

The Nursing Gender Gap

-Mid 1800s Florence Nightingale: argued for improved nursing education and status; contributed to declining number of men -Nursing seen as an extension of a woman's "natural domestic role" -Nursing came to be though of as "women's work" and of lower societal value than other male-dominated occupants -Historically, men were discouraged and other denied access to nursing education; Nightingale model refused to accept men -Now men make up almost 10% of all nurses

Allied Health

-Mid level health care professionals who support, complement, or supplement the work done by physicians and nurses -"Allied health" is a very broad term used to identify a cluster of health care professions encompassing over 100 occupational titles -The 5 M allied health professionals in the US represent 60% of our nation's health care providers

Nursing Shortage

-Neg impact on emergency preparedness, access to care, quality of care, patient safety, economic growth CAUSES: pop growth and aging population, not enough new students, educational resources,low job satisfaction and poor working conditions, high work force attrition rates, gender biases SOLUTIONS: wage incr, foreign nurses, new programs, retention strategies, incr incentives, incr nurse efficiency, better educate public on impact of nursing care on health care quality and safety

Clinical Laboratory Technologist (CLT)

-Perform chemical, biological, hematological, immunologic, microscopic, and bacteriological TESTS -EXAMINE & ANALYZE body fluids, tissues, and cells to identify bacteria, parasites, and other microorganisms -Analyze chemical constituents of body fluids, cross-match blood for transfusions, test blood for drug levels, monitor response to treatment

Surgical Technologist

-Prepare surgical suite PRE-OPeratively by setting up instruments, equipment, and sterile linen -DURING operative procedure, pass instruments, sponges, and other sterile supplies to members of surgical team

Registered Dietician (RD)

-Promote healthy EATING HABITS and provide advice on DIET MODIFICATION -Help decr malnutrition; promote healthy lifestyles and control

Certified Registered Nurse Anesthetist (CRNA)

-Safely provide anesthesia care to surgical, obstetrical and trauma patients -Usu work under direction of attending surgeon, dentist, or anesthesiologist -Study and interpret presurgical tests to determine how anesthetic will affect patient

Nursing

-The use of clinical judgment: to enable people to improve, maintain, or recover health; to help patients cope with health problems and to achieve the best possible quality of life -Highly skilled; lots of autonomy and career advancement -Types: CNA, LVN, RN, NP -Various practice settings

Physician Assistant (PA)

-UNDER direction of physician -Variety of medical services: medical history, physical exams, order tests & x-rays, care for minor injuries, counsel patients, prescribe medications and treatments

Radiologic/X ray/Ultrasound Technician

-Use x ray or ultrasound equipment for the diagnosis and treatment of diseases or injuries -Evaluate patient's condition, explain procedures, and adjust equipment to yield best image quality -Assist physicians in performing sophisticated or invasive procedures when imaging equipment is needed

Certified Nursing Assistant (CNA)

-Work under direction and supervision of RNs, LVNs, and other medical staff -Provide personal care such as cleaning/bathing, feeding and dressing -Perform support functions such as transporting patients, taking vital signs, making beds, helping patients become ambulatory and answering patient calls -Often responsible for observing and reporting how patients respond to the care that is being given

CCE Position Restrictions

-do NOT chart vital signs -do NOT read patient charts -can NOT enter restricted isolation rooms -can NOT transport certain patients alone -do NOT handle narcotics or medications

Clinical Laboratory Professionals

Clinical Lab techs and scientists -Not often personally or directly involved with patients but play a crucial role on patient care team -Generate vitally important DATA for identifying and treating various medical conditions -Verify presence or absence of disease and provide data that helps physicians determine the best treatment for the patient

Physician Hierarchy: AMA (low to high)

MED STUDENT: 3rd-4th yr rotate through clinical clerkships RESIDENT: finished med school; trained in specialty ATTENDING: completed residency; supervise residents and med students CHIEF OF DEPT CHIEF OF STAFF

PA vs NP

PA: TX DISEASE; role created by American Medical Association (AMA), Practice UNDER MD, similar role as MD NP: TX ENTIRE PATIENT & their RESPONSE to illness; focus largely on wellness; PREVENTION; practice INDEPENDENTLY; similar role as MD

MD vs DO

SIMILARITIES: prereqs, medical education, postgrad training, duties and responsibilites, salary depends on specialty NOT degree DIFFERENCES: USMLE vs COMLEX; DOs not as internationally recognized; DOs more often choose primary care specialties and serve rural/undeserved populations; MD=3.45 GPA/30 MCAT and DO=3.4/25

Who is the most important member of patient care team?

THE PATIENT! -last say on tx, should be allowed to make free and un-coerced decisions -Has control over what happens to their body