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Related Concept Videos

SBAR I: Understanding the Concept01:29

SBAR I: Understanding the Concept

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Effective communication among healthcare professionals during hand-off reporting is essential to delivering safe and continuous patient care. Common professional interactions include reports to healthcare team members, hand-off, and transfer reports. Nurses routinely report information to other healthcare team members and also urgently contact healthcare providers to report changes in patient status.
Standardized methods of communication have been developed to ensure that information is...
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Hospitals-II00:59

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Hospitals provide inpatient and outpatient services. Inpatient services provide care to patients that stay in the hospital for an extended period, ranging from days to months. Examples of inpatient services include intensive care units, hospital wards, or surgeries. Outpatient services provide care to patients who come to a hospital for a diagnostic or treatment but do not stay overnight —for example, diagnostic tests, surgical procedures, or health education.
Nurses that work in...
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Hospitals offer medical and surgical care to the sick and injured, along with accommodation while they recover. At the same time, they also provide outpatient, emergency, psychiatric, and rehabilitation services to meet various community needs. In addition to providing medical care, hospitals also act as hubs for medical research and training. Hospitals use clinical procedures and evidence-based practice standards to deliver patient care. To deliver safe and efficient care, a nurse must stay up...
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SBAR II: Application of SBAR01:14

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SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
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Standards of Care I01:22

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Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
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Health Information Technology and Healthcare Information System01:30

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Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
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Emergency Department Boarding, Inpatient Census, and Interhospital Transfer Acceptances.

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Hospital crowding, measured by emergency department boarding and inpatient census, significantly reduces interhospital transfer acceptance. This impacts patient access to specialized care, especially for rural and high-priority cases.

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Area of Science:

  • Healthcare Management
  • Health Services Research
  • Patient Access to Care

Background:

  • US referral hospitals face increasing crowding, leading to a rise in interhospital transfer (IHT) request refusals.
  • Hospital crowding poses risks to patient safety and challenges the core function of referral centers.
  • Refusal of IHTs can disrupt patient care pathways and potentially lead to adverse outcomes.

Purpose of the Study:

  • To quantify the association between hospital crowding metrics (emergency department [ED] boarding and inpatient census) and IHT acceptance rates.
  • To examine how crowding affects IHT acceptance for both general cases and prioritized medical conditions.
  • To analyze the impact of rurality on IHT acceptance in the context of hospital crowding.

Main Methods:

  • Cross-sectional study analyzing 26,020 IHT requests from a Level I trauma center in a rural Southwestern US state (January 2019 - May 2023).
  • Data included transfer center records, daily ED boarding hours, and inpatient census.
  • Adjusted logistic regression assessed the relationship between crowding measures and IHT acceptance, controlling for prioritized conditions and rurality.

Main Results:

  • Overall IHT acceptance rate was 61.7% (16,062 accepted out of 26,020 requests).
  • Increased ED boarding and inpatient census were negatively correlated with IHT acceptance (Pearson r = -0.73 and -0.87, respectively).
  • Higher ED boarding was associated with lower odds of IHT acceptance (aOR, 0.71). Rural requests had lower acceptance odds (aOR, 0.66) compared to urban.
  • Prioritized conditions like obstetrics, STEMI, and trauma had significantly higher acceptance rates.

Conclusions:

  • Severe hospital crowding, indicated by ED boarding and inpatient census, significantly decreases the acceptance of interhospital transfer requests.
  • Overcrowded referral hospitals must balance care for existing patients with accepting new transfers, creating a critical operational challenge.
  • Findings highlight the need for strategies to mitigate hospital crowding and ensure equitable access to specialized care, particularly for rural populations and critical conditions.