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Patients in the Hallways? | | Published by: smith 2009-01-07 |
| | Findings::
“Hospitals that are reluctant to board admitted emergency patients in inpatients hallways for safety reasons should be reassured by our research,” says lead
http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/12DEC2008/0812HHN_Scope_Findings&domain=HHNMAGHOME |
Has this been happening anywhere else? Just this past week, 4/30-5/4, the maintainance guys were up on the floors hanging hardware at the ends of the hallways on our units. We asked what was up. They responded with "these are for curtains for you guys to take the ER holds till you have beds available". Shock of shocks....since we nurses had no clue this was going to happen.
CBU Students with Patients in the Hallway::
First
http://www.cbu.edu/~aross/biology/Haiti/HMM-SlideShow-1/sld043.htmHOME |
In-Patient Hallway Boarding Lowers Mortality in ED Patients::
Emergency patients admitted to the hospital had lower mortality rates and admission to an intensive care unit when transferred from the emergency department
http://www.medscape.com/viewarticle/582834HOME |
Anyone whose worked in the field over the last 20 years or so.....remember "hall beds" for pts? They were outlawed by the fire department as major fire hazzards. So what's going on ? And what about the big brouhaha a few years ago about HIPPA? Patients being curtained off in a busy hallway will certainly NOT have privacy.....and will also be privy to all sorts of fellow pt. info at the nurse's stations they are across from. :confused:
Is my facility the only one doing this? Could the addition of these beds be in response to some info TPTB know....and we don't?
AHRQ Releases Standardized Hospital Bed Definitions
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Hospital bed definitions that can provide uniform terminology for organizations tracking the availability of beds in the aftermath of a public health emergency or bioterrorist event have been released by the Agency for Healthcare Research and Quality (AHRQ). Developed by AHRQ-supported researchers at Denver Health in Colorado, the definitions will allow hospital systems and emergency responders seeking beds to speak the same language. Definitions currently in use vary among systems and even among hospitals.
These standardized definitions were vetted by a working group assembled by Denver Health with members from Federal and State governments, hospitals around the Nation, and the private sector.
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Licensed Beds: The maximum number of beds for which a hospital holds a license to operate. Many hospitals do not operate all of the beds for which they are licensed.
Physically Available Beds: Beds that are licensed, physically set up, and available for use. These are beds regularly maintained in the hospital for the use of patients, which furnish accommodations with supporting services (such as food, laundry, and housekeeping). These beds may or may not be staffed but are physically available.
Staffed Beds: Beds that are licensed and physically available for which staff is on hand to attend to the patient who occupies the bed. Staffed beds include those that are occupied and those that are vacant.
Unstaffed Beds: Beds that are licensed and physically available and have no current staff on hand to attend to a patient who would occupy the bed.
Patients waiting for hospital beds - KevinMD.com::
Patients waiting for hospital beds. It is common to find patients waiting for admission sitting in the hallways of emergency departments.
http://www.kevinmd.com/blog/2008/10/patients-waiting-for-hospital-beds.htmlHOME |
SCVTalk.com » Blog Archive » Conversations : Maria Gutzeit Interview::
Mar 18, 2008 Of course, Roger Seaver needs those patients in the hallways to “prove” a hospital expansion is necessary, a hospital expansion Roger and
http://scvtalk.com/2008/03/18/conversations-maria-gutzeit-interview/HOME |
Occupied Beds: Beds that are licensed, physically available, staffed, and occupied by a patient.
Vacant/Available Beds: Beds that are vacant and to which patients can be transported immediately. These must include supporting space, equipment, medical material, ancillary and support services, and staff to operate under normal circumstances. These beds are licensed, physically available, and have staff on hand to attend to the patient who occupies the bed.
The relationship between the different types of beds is shown below.
Figure 1. Licensed Hospital Beds
Beds also can be categorized according to the type of patient they serve:
Adult Intensive Care (ICU): Can support critically ill/injured patients, including ventilator support.
Medical/Surgical: Also thought of as Ward beds.
Burn or Burn ICU: Either approved by the American Burn Association or self-designated. (These beds should not be included in other ICU bed counts.)
Pediatric ICU: The same as adult ICU, but for patients 17 years and younger
Pediatrics: Ward medical/surgical beds for patients 17 and younger
Psychiatric: Ward beds on a closed/locked psychiatric unit or ward beds where a patient will be attended by a sitter.
Workforce Management Community Center: Legal Forum::
4 posts - Last post: Feb 28, 2000She is willing to remove the face wrap for when she's treating patients, but will put it on when in the hallways.
http://www.workforce.com/phpBB/viewtopic.php?topic=17963&forum=54&3HOME |
Negative Pressure/Isolation: Beds provided with negative airflow, providing respiratory isolation. Note: This value may represent available beds included in the counts of other types.
Operating Rooms: An operating room that is equipped and staffed and could be made available for patient care in a short period.
For purposes of estimating institutional surge capability in dealing with patient disposition during a large mass casualty incident, the following bed availability estimates also may be reported:
24-hour Beds Available: An informed estimate of how many staffed, vacant beds for each category above could be made available above the current number within 24 hours. This would include created institutional surge beds as well as beds made available by discharging/transferring patients.
72-hour Beds Available: An informed estimate of how many staffed, vacant beds for each category above could be made available above the current number within 72 hours. This would include created institutional surge beds as well as beds made available by discharging/transferring patients.
Use of these standardized definitions and estimates of future bed availability will provide greater consistency among hospitals in reporting bed availability information.
Current as of September 2005
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Internet Citation:
AHRQ Releases Standardized Hospital Bed Definitions to Aid Katrina Responders. September 2005. Agency for Healthcare Research and Quality, Rockville, MD.
http://www.ahrq.gov/research/havbed/definitions.htm
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Return to Public Health Preparedness
Research Findings
AHRQ Home Page
Department of Health and Human Services
THIS ARTICLE CAN BE VIEWED HERE:
http://www.ahrq.gov/research/havbed/definitions.htm
Recently, my father was taken to the ER due to passing out and a suspect EKG done by the ambulance crew. He waited for 5+ hours on a gurney in ER hallway before being taken to an exam room. Another 2 hours later he was released after tests were repeated and reviewed by a doc.
When I inquired about the lack of rooms and the long wait, a nurse said it was a typical weekday - weekends were worse.
Well, it does seem unusual that despite the fire hazard problem, this type of thing is happening at her hospital. Nevermind the HIPPA issue. How do they get past that fire hazard violation? She does not work in an inner city hospital. She also did not say it was for pandemic flu. No real reason was given to the staff.
Given all that, you have to wonder, why are they doing this?
RE:
http://www.faegre.com/articles/article_1882.aspx
The reference cited is an interesting promotion for preparedness but 1) it is not an official notice; 2) it does not provide a source for the statement that bird flu may arrice in 3 to 6 months; and 3) it does not clearly state that it means pandemic versus simply avian flu affecting poultry.
As for ER holds in hallways, that is an everyday occurence in most urban trauma centers now even without pandemic flu. I cannot say why any facility would focus on curtains as a significant preparation for a pandemic when there are so many other high priority tasks such as training, drills, communications, etc.
Joe Thornton, M.D.
Thanks for letting us know. I don't work in hospitals but I will ask
my friends that do.
Avian Flu Pandemic Preparation for Employers
Government experts are now projecting that the bird flu virus (H5N1) may reach the United States in the next three to six months. :confused: If avian flu becomes a pandemic, the Centers for Disease Control (CDC) estimates there could be as many as two million infected people, and 100,000-200,000 or more deaths, in the U.S. alone. Experts recommend that employers make contingency plans now. (See CDCs website for more information on bird flu, and recommendations for pandemic preparation.) Many employers will be able to build on disaster contingency plans they developed in response to severe acute respiratory syndrome (SARS) and other disasters. See our previous publication, Dealing With SARS Issues in the Workplace.
Typical Subjects for Contingency Plans. Although avian flu contingency plans vary among employers based on business needs, most plans focus on:
business continuity planning cross-training employees and building a telecommuting infrastructure to permit employees to work from home.
travel restrictions/evacuation preparation monitoring conditions throughout the world to determine when to evacuate expatriates and when to restrict business travel to certain locations.
procedures for detecting and mitigating the spread of bird flu in the workplace.
Potential Issues. Contingency plans with these elements raise several benefit and employment law issues:
As an overriding principle, workplace safety law requires employers to provide a workplace free from recognized hazards likely to cause death or serious physical harm (See the Occupation Safety and Health Administrations current guidance on avian flu);
Employers must be concerned about how they will be able to detect bird flu symptoms among employees and communicate information to affected employees and others without violating applicable privacy laws. In general, the HIPAA privacy rules will not govern such uses and disclosures of health information related to the bird flu, unless employers obtain such health information from their health plans. Further, HIPAA may permit uses or disclosures of protected health information which are necessary for public health reasons that is, to prevent or control the spread of bird flu. Employers should also check state medical privacy rules regarding such issues. Finally, the Americans with Disabilities Act and many state fair employment practices statutes may also affect an employers ability to make disability-related inquiries or to require an employee to undergo a medical examination.
Employers may need to review their leave policies to see whether changes are necessary to permit extended leaves, and continuation of benefits and pay during such leaves, in order to encourage sick and/or exposed workers to stay home. FMLA-eligible employees with bird flu symptoms or infection, or who take leave to care for sick family members, should qualify for FMLA leave. However, there will likely be many absent employees who do not qualify or are not eligible for FMLA leave.
Employers may want to consider starting an Employee Assistance Plan to address stress and emotional issues involved with pandemics, and as an additional resource to assist employees with pandemic preparation. Employers who already have EAPs should check whether EAP resources are available to assist them and their employees with preparation for a bird flu pandemic.
It is reasonable to expect that if a pandemic does occur, the IRS and Department of Labor would issue relief from benefit plan requirements similar to what we have seen in the wake of Hurricane Katrina.
Undoubtedly, if migrating birds infected with bird flu reach the United States, the CDC and other experts will issue new recommendations and guidelines. We will be monitoring these developments as they unfold. If you have any questions in the course of preparing your bird flu pandemic contingency plans, please contact one of our benefits or employment lawyers.
http://www.faegre.com/articles/article_1882.aspx
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