An Analysis of Restructuring Orientation to Enhance Nurse Retention.

The nursing shortage has received much media attention; however, something that contributes to it-nurse turnover-has not received the same attention. Facilities spend time and money to train new employees only to have them leave within a few months. Staff morale, money, time, and quality of care are all affected by nurse turnover. The fact that it often occurs so soon after one takes a position makes it pertinent to look at the process of transition into the new position, namely, the orientation program. This article examines the turnover statistics, costs, rationale, and orientation programs that have proven positive results. It is hoped that the findings can assist health care facilities to replicate successful orientation programs and reduce nurse turnover.

Health Insurance Portability and Accountability Act Violations by Physician Assistant Students: Applying Laws to Clinical Vignettes.

Students enrolled in medical schools, nursing schools, and physician assistant (PA) programs are required to have instruction on patient privacy and protection of health-related information. The medical literature has several examples of breaches of patient privacy by clinicians, which likely represents only a fraction of the violations that occur. Patient privacy and the protection of health-related information constitute both an ethical issue and a legal issue and are associated with significant consequences. Medical, PA, and allied health students are required to comply with the same federal laws related to patient privacy and confidentiality as licensed professionals. Universities must work diligently to create a culture in which students are taught about the legal requirements of the federal Health Insurance Portability and Accountability Act (HIPAA) and are held accountable for compliance with such requirements. The Health Insurance Portability and Accountability Act must be considered part of standard classroom instruction and be embedded and upheld at all clinical training sites. We present a series of 7 HIPAA violations by PA students, along with a brief description of the HIPAA provisions associated with each case. These real-life examples provide a comprehensive overview of important HIPAA components and illustrate how easily violations can occur in clinical settings.

Using Organizational Development for Electronic Medical Record Transformation.

With mandates requiring the transition from paper medical records to the use of electronic medical records, organizations are embarking on a change process. To engender this process, organizational development models and interventions based predominantly on the theories of Chris Argyris, Warren Bennis, and the team of Paul Lawrence and Jay Lorsch are explored. Interventions are subdivided into behavioral and structural as organizations benefit by recognizing a need for change and, perhaps, a cultural shift in addition to refocusing their mission. To support these interventions, a champion or super user is recommended to maintain the momentum of the transformation and enculturation. With so many changes in the internal and external environments, organizations must respond systematically for, in health care, lives depend on it.

An analysis of the management and leadership roles of nurses relative to the health insurance portability and accountability act.

Nurses have a great deal of interaction with patients. Given this, nurses play a vital role in conveying to patients knowledge of their privacy, security, and confidentiality of patient health information rights under the Health Insurance Portability and Accountability Act (HIPAA). Nurses also can be "at the head of the table" in their own organization and professional organizations in regard to facilitating the implementation of the HIPAA and making access to patient information more "consumer friendly." This article discusses the role that nurses can develop into concerning HIPAA implementation in an ever-burgeoning arena of consumer advocacy and consumer information.

Developing a virtual nurses' station for community-based nurses.

Nurses who work throughout the community need a nurses' station, just as nurses who work in a hospital. The nurses' station is the area where communication, information sharing, and documentation occur. This article describes how a virtual nurses' station was created using Blackboard technology to meet the needs of nurses who are scattered throughout a geographic area. These nurses work in several urban neighborhoods to conduct the outreach services offered through an academic nurse-managed wellness center to community-dwelling older adults. Results have been positive as the virtual nurses' station provides the nurses an area to exchange data and information, print patient health care information, and access nursing policies. Satisfaction surveys from the nurses give valuable input on the design and use of the virtual nurses' station.

An analysis of restructuring orientation to enhance nurse retention.

The nursing shortage has received much media attention; however, something that contributes to it-nurse turnover-has not received the same attention. Facilities spend time and money to train new employees only to have them leave within a few months. Staff morale, money, time, and quality of care are all affected by nurse turnover. The fact that it often occurs so soon after one takes a position makes it pertinent to look at the process of transition into the new position, namely, the orientation program. This article examines the turnover statistics, costs, rationale, and orientation programs that have proven positive results. It is hoped that the findings can assist health care facilities to replicate successful orientation programs and reduce nurse turnover.

HIPAA and FERPA: competing or collaborating?

The Family Educational Rights and Privacy Act (FERPA) was established in 1974 to protect the privacy of student educational records. The Health Insurance Portability and Accountability Act (HIPAA) had its first part implemented in 2002 with the goal of protecting the privacy of patient health information. But what happens when the student is a patient? Does one follow FERPA or HIPAA or both? This article examines that question and guides schools through the HIPAA/FERPA intersection. Schools need to consider their individual situations, as there is not a "one size fits all." In addition, one word in the HIPAA or FERPA law can make a difference. What also has to be taken into account is individual state law where the school or patient is located. It is hoped that in the future the language of the laws will be ameliorated such that the focus can be on the students and patients and not deciphering what law to follow.

HIPAA: SOP: HIPAA as standard operating procedures.

Upon the debut of the Health Insurance Portability and Accountability Act (HIPAA), many health care managers felt that the implementation process would be too expensive, arduous, and time-consuming. Now, several years later, it is clear that the way to manage HIPAA is to make it a part of one's standard operating procedures. Using this approach, HIPAA is cost-effective, manageable, and efficient. Health care managers can utilize the step-by-step procedures presented here to efficaciously implement and manage HIPAA.

An analysis of the utilization of e-mail by physicians and patients: defining benefits, addressing concerns and forecasting implications on the doctor-patient relationship.

Though e-mail is ubiquitous in everyday life, it has not been the preferred mode of communication between physicians and patients. Several factors, including privacy and security, reimbursement and legal concerns, have been seen as barriers toward increased utilization. This article examines effect of e-mail on the doctor-patient relationship. It also addresses concerns expressed by providers and patients, and explores technology- and policy-based solutions to many of these issues.

Halfway there? Check to see if you are: six of 11 health insurance portability and accountability act rules are set.

The Health Insurance Portability and Accountability Act contains 11 rules, 6 of which have been released to date. Within each of the rules are numerous actions to be implemented. This article reviews those actions and provides health care managers with what exactly needs to be done to be in compliance with the Health Insurance Portability and Accountability Act effectively and efficiently.

The digital divide: Internet and e-mail use by the elderly.

The elderly are the fastest growing population group. Along with their rise in numbers is their volume of use of health care services, in both number and intensity. Since many elderly live alone, can their independence be maintained such that health care costs can decrease? With the rise in technology utilization, specifically the Internet, can the elderly utilize the Internet for health care purposes? Survey methodologies conducted for this study showed that the elderly can learn to use computers and are looking for methods to stay connected and be informed. Further longitudinal research is needed to measure clinical outcomes.

Web-based communication to enhance outcomes: a case study in patient relations.

As the volume of available resources on the Internet continues to expand, more people turn to the Web first when researching healthcare topics and conditions. In fact, nearly three quarters--73 percent--of 12,000 Internet users in a recent survey conducted by Gomez Advisors Inc., a Lincoln, Mass.-based research and consulting company, reported that they had researched a health condition on the Web. Conducting research on a particular health condition on the Internet often yields vast amounts of information, much of it not relevant, specific, or even accurate. Therefore, it is important to tailor a search to elicit results that will be the most precise to a specific situation. Web sites that use "push technology," such as targeted e-mail, rather than a passive site that must be visited and surfed through, offer a more effective way of obtaining "just-in-time" information. Such sites are able to reach people with pertinent information that will spark their interest, assist them in formulating questions when speaking to their physicians, and, above all, improve their own well-being. This article discusses a particular push technology strategy, how outcomes information was obtained to validate the strategy, and the results for a particular healthcare diagnosis.

HIPAA implementation: measuring change and quality improvement.

Implementing appropriate practices to achieve compliance with HIPAA regulations is a multifaceted task. Implementation is a work in progress because the regulations are in various stages of release. As complex working environments, healthcare organizations must consider the individual roles of their staff in devising an appropriate and effective HIPAA strategy.

Electronic managed care: the utilization of information technology in a managed care environment.

Health care managers must use information technology in managed care negotiations with all players in the managed care model-employers, managed care organizations, providers, and patients. Information technology effectuates these negotiations, provides a value added to all those involved in terms of efficiency and communication, and helps managers remain within regulations. This article describes each phase of the managed care model and how information technology is used. It also provides an operational overview of how to integrate the technology into health care settings.

Combining mandatory health insurance and medical savings accounts.

The American tradition of freedom of choice is mirrored exceptionally well in the health care industry. The consequences of this system are the highest health care costs in the world and 38.7 million uninsured. Implementation of mandatory, high-deductible health insurance in conjunction with a medical savings account for every resident could have several benefits, and it may engender bipartisan support.