Wednesday, August 29, 2012

Be Careful For Elders - Select Senior Care

When people get old and get retired, then most of the times they got nothing to do with the time available to them.
This results in the frustration and depression and which causes the mental an the physical illness.
This is the time where need to be cared more but ironically the youngsters don't have enough time to spend with their elders.
This problem of yours is being solved by the many home care facilities and the care centers for the elders.
The senior care could be best done if you know about what the needs of your loved ones are in the part of their age.
For the further planning you need to make a list of their requirement first.
There are two types of the elderly care.
The first one is senior care centers and the second one is home care facilities.
If one has to choose the elder care center, then some things should be kept in mind.
1. The senior care center you are selecting should be having the government registration.
2. The owners and the workers of the centers must have expertise in their field.
3. The caretakers should be treated with the smile and the friendly attitude by the caregivers.
4. There must be appropriate number of staff as compared to the residents.
5. The staff members and the resident should be of same language or should understand the language of each other.
6. The care givers should spend the sufficient time with the people.
7. The senior care centers should have the clean, hygienic and the friendly environment.
8. Do the elders could keep their pets in the elderly care center as many of the elders are too much attached with them.
9. You must see that either the smoking allowed by the center authority or not as many of the elders love to smoke.
10. There must be a proper security arrangement in the center.
11. For the worshipping in the church and going for the part; so is there any transport facility in senior care center or not.
12. The elders are spending the money and do that money is being managed by the care givers or not.
13. The daily living activities of the elders like toileting, bathing or doctor's appointment is being facilitated by the staff members or not.
14. The caregivers should fill the prescription and should remind the medicine to the elders.
15. The senior care centers should keep a good care of your elders and in the case of the food as well and they must provide the food according to the taste of your loved ones.
The elders who would have to live there should be the part of the discussion about the selection of the center.
If they are in need of the anything else then it must be arranged for them.
Nothing could be comparable with the facilities we enjoy at home but still we can try our best to provide maximum to our elders.
Your elders would be enjoying the non-medical service just by sitt8ing at the home if you select the home care.
senior care center should not be selected by the elders who want to stay at home but also want to enjoy the service as the right choice which could give them these two is the home care.
And this is because of the selection of the elders for the assistance in the daily activities like bathing, dressing and meal preparation.
Some also want the company and the emotional support and some assistance in paying bills and transportation as well.
The time span of the assistance depend upon our elders.
The charges of the home care are basic thing as it sometimes determine the selection.

Insurance cover for OPD

Those spending a fortune on the treatment of some chronic diseases but not getting insurance benefits because their treatment does not require hospitalisation will now have something to cheer.
Health insurance plans, which until now covered expenses only if the insured is hospitalised, will soon include outdoor patient department (OPD) benefits and dental care in their ambit. The inclusion of OPD benefits imply that the insured need not be hospitalised to seek insurance benefits.Typically, health insurance plans cover treatment expenses when the insured is hospitalised for more than 24 hours.But, some of the insurance companies like Bajaj Allianz General Insurance and Max Bupa are planning to provide such services in the wake of the government’s directive to make insurance sector more attractive to consumers. Sources from these companies said an inclusive health care plan with OPD cover will likely be in the market by the year-end.With a few exceptions, Indian insurance companies have products without OPD cover. A handful of those providing OPD cover charge additional premium.“The objective of this policy is to provide the policy holders with maximum insurance benefit under the policy.The new plan will covers all OPD expenses like consultation with the doctor, pathological tests and medicines,” said Anand Nandan, head of the health segment in Bajaj Allianz.In recent times, there is an increase in the number of dialysis patients and those down with arthroscopy, who do not need hospitalisation for more than 24 hours, but incur huge medical expenses and the insurance cover can benefit them.Women with complicated deliveries also need a series of pre-natal tests and medication, which have resulted in higher childbirth expenses. Health insurance with OPD cover is thus beneficial for women during pregnancy and childbirth.Some non-life insurance companies are in the process of launching retail health insurance policies that cover alternative forms of treatments, while several insurers, which already cover such treatments, are in the process of increasing the limits.The country’s largest general insurer, New India Assurance, which covers alternative treatments up to 25 per cent of the sum insured, has already filed a product with the regulator, the Insurance Regulatory and Development Authority (IRDA), with higher limits.ICICI Lombard General Insurance, the largest private insurer, too has filed for approval of a product with Irda that will provide OPD coverage under alternative treatments, but without hospitalisation benefit.Alternative treatments referred to as Ayush (Ayurveda, Unani, Siddha, and homeopathy) is so far offered by a mere seven non-life insurers out of 24 companies with limits and conditions. The insurers that cover hospitalisation under alternative treatments are New India Assurance, United India, Oriental Insurance, National Insurance, Tata AIG, HDFC Ergo General and Cholamandalam General Insurance.

When Nurses Make Mistakes

In the medical profession nowadays, it is more important than ever to take care to avoid mistakes. Nursing errors do not just cost money or interrupt business; they cost lives. All good medical professionals know this. However, sometimes mistakes can happen despite the nurse’s best intentions, leading patients to sue for medical misadventure. Other times, claims are simply made by money-hungry patients or their family members. The value of these claims can be extraordinarily high — too high for a nurse to handle by him or herself. That is where professional indemnity insurance for nurses comes in.

Medical indemnity insurance protects nurses against claims of negligence, board investigations and inquiries, formal complaints dealing with non-medical aspects of the business, and more. There are many different levels of indemnity insurance, so it is important to shop around and ensure that the needs of a particular nurse or practice are met by the insurance policy that is finally purchased. Having too little insurance can be just as disastrous as paying for too much.

Medical indemnity insurance needs to be carried for a certain length of time even after the nurse has retired from practice. This is due to the fact that indemnity insurance is occurrence-based; that is, coverage is for when the claim is made, not when the incident under investigation happened. Claims might be made after the practitioner has retired or otherwise left practice, and if there is no current indemnity policy, the responsibility for the value of the claim rests squarely with the nurse.

While all nurses do their best to protect the lives of their patients, it is inevitable that mistakes will happen. Even if they did not, lawsuits are often filed against perfectly innocent medical practitioners. Professional indemnity insurance for nurses protects them against claims of negligence, whether or not those claims are valid. Having coverage for those kinds of situations is a vital part of being a nurse, and thus professional indemnity insurance is something no nurse can afford to be without.

Holiday Insurance

Holiday Insurance plans are one of the most important policies. These insurance policies are designed for the once who are planning to set out on a holiday. Just as in case of other insurance plans Holiday Insurance helps you have cover for a number of unfortunate situations during your holidays. While traveling your health, belongings as well as your life can be at stake. By getting these insurance policies you can have a great holiday where you will not to worry about what will happened in case of an unfortunate incident during your trip. These policies provide you with peace of mind in addition to providing you with cover for a number of serious situations that are common during holidays.

To find a suitable Holiday Insurance plans you can explore the internet. There are various insurance providers online that can provide you with Holiday Insurance plans to make your trip safe and enjoyable in the best possible manner. As different insurance plans have different cover it is vital for every traveler to have an idea of the kind of cover he or she would like to have. Some Holiday Insurance plans may provide you with cover for your health while others may help you have cover for your valuable belongings that you will like to carry on your trip. The kind of insurance plans that you should pick on your own choice and preference also depends on your budget. This is why while selecting a Holiday Insurance policy you should have a clear idea of what you really want and how much you can afford to spend.

If you have a limit budget and you want to avail a Holiday Insurance within that it is certainly possible as there are various insurance providers that understand the limitation of different travelers. For the once who cannot afford to spend much on this insurance plan a number of affordable policies are offered by insurance companies that make it easy for everyone to pick a suitable Holiday Insurance without any problem. Doing research on the internet on the basis of your need is a simple and effective way to find suitable Holiday Insurance plans that can be within your budget and also provide you with the type of cover that you want. So when you plan your next holidays do not forget having Holiday Insurance so that you can make the most of your trip and incase of any unfavorable incident get the much needed cover that can save you for financial burden.

Medical-surgical Nursing : Patient-centered Collaborative

Medial surgical nursing book used or one class in nursing school. All chapters neatly tabbed for easy access

edges slightly used and worn.Posted with eBay MobileFormat: Trade ClothLanguage: EnglishPublisher: Elsevier – Health Sciences DivisionTitle: Medical-Surgical Nursing : Patient-Centered Collaborative Care by Donna D. Ignatavicius and M. Linda Workman (2009, Hardcover)ISBN: 9781416037620Additional Information about Medical-Surgical Nursing : Patient-Centered Collaborative Care by Donna D. Ignatavicius and M. Linda Workman (2009, Hardcover)Certain data records © 2012 Bowker. Rights in cover images reserved by owners.SynopsisWritten by two expert authors, this trend-setting textbook of medical-surgical nursing offers cutting-edge content that’s easy to understand. The sixth edition includes a new emphasis on clinical decision-making for patient-centered collaborative care and more streamlined and balanced coverage of the core body of knowledge needed for safe clinical practice. There is also expanded coverage of emergency and disaster preparedness along with an enhanced “Get Ready for the NCLEX Examination” feature that includes the addition of new NCLEX Challenge questions.

Product IdentifiersISBN-101416037624ISBN-139781416037620
Key DetailsAuthorDonna D. Ignatavicius, M. Linda WorkmanNumber Of Pages1968 pagesFormatTrade ClothPublication Date2009-02-11LanguageEnglishPublisherElsevier – Health Sciences Division
Additional DetailsEdition Number6Copyright Date2009IllustratedYes
DimensionsWidth8.8 In.Length11.1 In.
Target AudienceGroupCollege Audience
Classification MethodLCCN2008-045867LC Classification NumberRT41.I36 2009Dewey Decimal617/.0231Dewey Edition22
Table Of ContentTable Of ContentUNIT I. FOUNDATIONS FOR MEDICAL-SURGICAL NURSING 1. Introduction to Medical-Surgical Nursing 2. Introduction to Complementary and Alternative Therapies 3. Common Health Problems of Older Adults 4. Cultural Aspects of Health and Illness 5. Pain: The Fifth Vital Sign 6. Genetic Concepts for Medical-Surgical Nursing 7. Substance Abuse and Medical-Surgical Nursing 8. Rehabilitation Concepts for Chronic and Disabling Health Problems 9. End-of-Life Care UNIT II. CONCEPTS OF EMERGENCY CARE AND DISASTER PREPAREDNESS 10. Concepts of Emergency and Trauma Nursing 11. Care of Patients with Common Environmental Emergencies 12. NEW! Concepts of Emergency and Disaster Preparedness UNIT III. MANAGEMENT OF PATIENTS WITH FLUID, ELECTROLYTE, AND ACID-BASE IMBALANCES 13. Assessment and Care of Patients with Fluid and Electrolyte Imbalances 14. Assessment and Care of Patients with Acid-Base Imbalances 15. Infusion Therapy UNIT IV. MANAGEMENT OF PERIOPERATIVE PATIENTS 16. Care of Preoperative Patients 17. Care of Intraoperative Patients 18. Care of Postoperative Patients NEW! HUMAN NEEDS OVERVIEW: PROTECTION UNIT V. PROBLEMS OF PROTECTION: MANAGEMENT OF PATIENTS WITH PROBLEMS OF THE IMMUNE SYSTEM 19. Inflammation and the Immune Response 20. Care of Patients with Arthritis and Other Connective Tissue Diseases 21. Care of Patients with HIV Disease and Other Immunodeficiencies 22. Care of Patients with Immune Function Excess: Hypersensitivity (Allergy) and Autoimmunity 23. Cancer Development 24. Care of Patients with Cancer 25. EXPANDED! Care of Patients with Infection UNIT VI. PROBLEMS OF PROTECTION: MANAGEMENT OF PATIENTS WITH PROBLEMS OF THE SKIN, HAIR, AND NAILS 26. Assessment of the Skin, Hair, and Nails 27. Care of Patients with Skin Problems 28. Care of Patients with Burns NEW! HUMAN NEEDS OVERVIEW: OXYGENATION AND TISSUE PERFUSION UNIT VII. PROBLEMS OF OXYGENATION: MANAGEMENT OF PATIENTS WITH PROBLEMS OF THE RESPIRATORY TRACT 29. Assessment of the Respiratory System 30. Care of Patients Requiring Oxygen Therapy or Tracheostomy 31. Care of Patients with Noninfectious Upper Respiratory Problems 32. Care of Patients with Noninfectious Lower Respiratory Problems 33. Care of Patients with Infectious Respiratory Problems 34. Care of Critically Ill Patients with Respiratory Problems UNIT VIII. PROBLEMS OF CARDIAC OUTPUT AND TISSUE PERFUSION: MANAGEMENT OF PATIENTS WITH PROBLEMS OF THE CARDIOVASCULAR SYSTEM 35. Assessment of the Cardiovascular System 36. Care of Patients with Dysrhythmias 37. Care of Patients with Cardiac Problems 38. Care of Patients with Vascular Problems 39. Care of Patients with Shock 40. Care of Patients with Acute Coronary Syndromes UNIT IX. PROBLEMS OF TISSUE PERFUSION: MANAGEMENT OF PATIENTS WITH PROBLEMS OF THE HEMATOLOGIC SYSTEM 41. Assessment of the Hematologic System 42. Care of Patients with Hematologic Problems NEW! HUMAN NEEDS OVERVIEW: MOBILITY, SENSATION, AND COGNITION UNIT X. PROBLEMS OF MOBILITY, SENSATION, AND COGNITION: MANAGEMENT OF PATIENTS WITH PROBLEMS OF THE NERVOUS SYSTEM 43. Assessment of the Nervous System 44. Care of Patients with Problems of the Central Nervous System: The Brain 45. Care of Patients with Problems of the Central Nervous System: The Spinal Cord 46. Care of Patients with Problems of the Peripheral Nervous System 47. Care of Critically Ill Patients with Neurologic Problems UNIT XI

Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume, 8e (MEDICAL SURGICAL NURSING (LEWIS)) Overview

Written by a dedicated team of expert authors led by Sharon Lewis, Medical-Surgical Nursing, 8^th Edition offers up-to-date coverage of the latest trends, hot topics, and clinical developments in the field, to help you provide exceptional care in today's fast-paced health care environment. Completely revised and updated content explores patient care in various clinical settings and focuses on key topics such as prioritization, clinical decision-making, patient safety, and NCLEX^® exam preparation. A variety of helpful boxes and tables make it easy to find essential information and the accessible writing style makes even complex concepts easy to grasp! Best of all - a complete collection of interactive learning and study tools help you learn more effectively and offer valuable, real-world preparation for clinical practice.

Provides a strong foundation in medical-surgical nursing in a highly readable format.
All content is written and reviewed by leading experts in the field to ensure that information is comprehensive, current, and clinically accurate.
Colorful design and over 1,400 full-color illustrations clearly demonstrate disease processes and related anatomy and physiology.
UNIQUE! A complete collection of study tools and resources, including the innovative Stress-Busting Kit for Nursing Students, offers engaging, interactive exercises and activities that make learning more effective and help prepare you for clinical practice.
UNIQUE! Presents key nursing management content using a "levels of care" approach that explains how nursing care varies for different levels of health and illness.
Approximately 55 comprehensive nursing care plans incorporate NIC, NOC, and current NANDA diagnoses, defining characteristics, expected outcomes, specific nursing interventions with rationales, evaluation criteria, and collaborative problems.
Bridge to NCLEX Examination Review Questions at the end of each chapter focus on prioritization and help reinforce your understanding of key content.
Evidence-Based Practice boxes summarize key interdisciplinary research and clearly demonstrate how it applies to nursing practice.
Collaborative Management headings and Collaborative Care tables emphasize the importance of total patient care in today's health care settings and provide a clear understanding of each provider's role in managing disorders.
Drug Alert boxes highlight important considerations applicable to key drugs.
Healthy People boxes summarize government health care goals as they relate to specific disorders and identify important strategies for the prevention and early detection of diseases.
Drug Therapy tables highlight vital medication information for quick reference.
Nutritional Therapy tables summarize nutritional interventions and strategies for promoting healthy lifestyles in patients with various conditions.
Cultural and ethnic health disparities content includes a dedicated chapter on health disparities and culturally competent care, as well as summary boxes highlighting important issues (including risk factors) related to the nursing care of various ethnic populations.
Extensive gerontologic content discusses age-related changes for each body system and alerts you to differences often encountered in older patients.
Emergency Management tables outline the treatment of health problems most likely to create medical emergencies.
Health History tables summarize the key questions you should ask, as well as important assessment parameters.
Patient and Caregiver Teaching Guides provide critical information to help you educate others who will be helping to care for the patient.
Ethical Dilemmas boxes promote critical thinking for timely and sensitive issues such as informed consent, patient adherence, guardianship, confidentiality, and sterilization.
Complementary and Alternative Therapies boxes summarize what you need to know about the clinical uses, effects, and nursing implications of herbal remedies, acupuncture, biofeedback, and more
Genetics in Clinical Practice boxes cover key topics such as genetic testing, Alzheimer's disease, sickle cell disease, and genetics-related ethics issues.
A glossary of key terms and definitions in the back of the book provides definitions and page references.

Completely revised and revamped content is more readable, concise, and user-friendly.
Reorganized coverage reflects an increased emphasis on more common disorders versus rare disorders.
An increased focus on prioritization is featured throughout the text and in the review questions, nursing care plans, and case studies.
Expanded coverage of delegation includes Delegation Decisions boxes throughout the text that highlight specific topics and skills related to delegation.
End-of-chapter Clinical Decision-Making Exercises feature case scenarios that emphasize prioritization, delegation, and concept mapping.
End-of-chapter review sections now feature alternate item-format questions.
Safety Alerts highlight patient safety issues and focus on the latest National Patient Safety Goals.
Pathophysiology Map flow charts make it easier to visualize and understand changes occurring in major diseases.
Focused Assessment boxes reflect a realistic "assessment on the run" approach and offer brief checklists for evaluating the status of previously identified health problems and monitoring for signs of new problems.
Assessment Case Studies for all assessment chapters help reinforce the importance of integrating and prioritizing assessment findings.
UNIQUE! A separate Sleep and Sleep Disorders chapter expands upon this key topic that impacts multiple disorders and body systems, as well as nearly every aspect of daily functioning.
UNIQUE! The Patient and Caregiver Teaching chapter emphasizes the increasing importance and prevalence of patient management of chronic illnesses and conditions, as well as the role of the caregiver in patient care.
The Emergency, Terrorism, and Disaster Nursing chapter features expanded coverage of terrorism.
Revised Infection chapter features updated infection control guidelines, an expanded section on emerging and reemerging infections, and new information about prions and H1N1 flu.

Travel Insurance Canada 2012

If you are planning an international trip you must consider travel insurance. Travel insurance plans are designed to help people get their hand on financial assistance in case they have to pay some unfortunate incidents during their journey or while they are stay in a foreign land. Through Travel Insurance you can get cover for your health or protection for your belongings and many other facilities in an easy way. Keeping in view the unprotect ability of life wise travelers always opt for travel insurance. Cheap Travel Insurance is also available which means that you can avail suitable insurance policies despite of your limited financial resources.There are various insurance companies has offer Cheap Travel Insurance and enable travelers with limited budget to benefit from the great travel insurance plans. By having an insurance policy while traveling provides you with peace of mind. They also enable you to have an enjoyable journey and focus on your objective of your traveling. This is why before going anywhere in the world it is always recommended to get travel insurance plans so that you can get cover for your health, as well as protection for your valuable belonging in the best possible manners. Getting travel insurance online is a great idea as it helps to saves your time and energy. You can get a number of quotes from different insurance providers that will helps you know what your options are.There is no need to visit insurance providers personally as you can do it all sitting at the comfort at your home. The few clicks you can compare various travel insurance plans that will help you find Cheap Travel Insurance policy without any problem. Comparing different Cheap Travel Insurance is very important if you want to save money and also avail the best plan. This comparison helps you know what different insurance providers can do for you and what the cost of these policies is. However, while looking for Cheap Travel Insurance you must remember that to save a few bucks you must not let go of an insurance plan if you have to go a little over your budget. The key to find the most affordable and useful travel insurance is to do proper research and explore all your options. Even though it will takes some time or it is certainly worthwhile as it will allow you to save considerable money and also avail suitable travel insurance plan.

Thursday, August 23, 2012

The Office of National Nurse

Imagine
A national spokesperson for the nursing profession,to be created by the United States Congress.
A Registered Nurse in an offical government position to represent nursing to the public, deliver weekly speeches promoting health education and the nursing perspective while focusing national attention on the nursing profession.
Imagine
Volunteer National Nurse teams responding in times of crisis, or helping to deliver health education to the public.
You may not have to imagine for much longer.
What started as an op/ed piece in the New York Times written by Teri Mills, an RN and Nurse Educator from Portland, Oregon has turned into H.R. 4903, a bill to create an Office of the National Nurse.
Let’s add our voices to the many who have already supported this new representation of our profession.
Visit the National Nurse web site for information.
And check out the totally cool “store” where your purchase can help fund the passage of this bill (do I sound like I live with a teenager or what?). Teri makes it easy by giving you easy access to your representatives and ideas on how to facilitate the ongoing efforts to pass this bill.
Keep up with the latest by subscribing to the free email updates put out by the National Nurse team.
Is your representative in support of H.R. 4903?

Where You Can Earn Your Doctorate in Nursing

You have made the decision to move forward with your nursing career, and what a great choice you have made! The benefits and rewards of being a nurse are probably one of the most rewarding careers available today. A doctorate in nursing will take your career to a level that allows you expand your horizon in the health care industry.

Your decision to take to the next level your nursing career could one of the best decisions you have made in your life. Not just a noble profession, the nursing career offers you plenty of opportunities to grow both as a professional and as a person with a genuine sense of service.

If this is the direction you want to take in your life, then you must have a good start. You must learn how to earn your degree online. Online courses have done wonders to the nursing profession by allowing a lot of people to acquire the degree at the most convenient way possible. The online method of learning is excellent for working people who want to advance in their career without having to sacrifice their other occupations or move across the state. There are nurses who want to pursue a doctorate in nursing but become frustrated because they couldn’t find any of these available in their locality. For these people, the online method of earning a doctorate in nursing proves to be a great help.

Top Four Online Programs

There are good number of well-respected universities and colleges that offer quality online PhD program. We will mention some of them here.

1. Doctor Of Health Administration – Many online schools are offering this online . A few examples include the University of Phoenix.

2. Doctor Of Health Management, Promotion and Education – One school that offers this online is Walden University.

3. Doctor of Public Policy And Administration – Check the Internet for schools and universities that offer this online

4. Doctor Of Health Care Administration – the same schools mentioned above also offered this.

These are just four of the top nursing doctorate programs that are popular these days. How do you decide which of these is best suited for your? You can base your decision on which particular aspect of the nursing profession you love doing and you excel in. If you think you are good in the administrative aspect of the nursing profession, then the health administration doctorate program is for you. If what makes you happy is the educational aspect of the nursing profession, then you might consider choosing the following such as health management, promotion and education. You can also explore other specializations, such as holistic medicine and natural health. These areas are not yet so populated, making growth in your career more ensured. The choice is yours.

Tuesday, August 14, 2012

Breastfeeding Sports Bras - Nursing and exercise made easy!

We absolutely love our Nursing Sports Bras from La Leche League - yet another first for New Zealand bought to you by Belly Beyond!

But don't just take our word for it here's more awesome customer feedback.

Vicki from Auckland:

The bra is excellent for light exercise and was great for Round the Bays. I do wear my heavy duty Bendon bra for running as the LLL ones don't offer enough support for this level of intensity. I love the convenience of being able to feed after a long walk while having slightly more support than a normal feeding bra. I also like the shape of the straps etc as they allow me to wear more sporty tops without my bra showing.

.... I downsized to a L and it fits firmly and feels comfortable especially around the underarm area. I like the way the bra is stitched through the centre of the breast area as it sits flat against my chest wall and absorbs sweat before it can run down the middle and cause a sweat rash due to friction. The band around the chest is nice and wide and also sits flat against the body. The breasts themselves feel well supported (like someone is cupping them for you).

Fiona from Christchurch:

I bought the bra after seeing your video of it. I wear it for walking only but like that I can feed easily if I need to but I'm not having to compromise support. It feels very comfortable and has been good motivation to start to exercise since my sons birth.

Lisa from Hamilton:

..... Another shop said that these types of bras didn't exist so I was pleased to find them available in NZ and I'm going to buy another one - thanks Belly Beyond!!

Sarah from Auckland:

Just received my La Leche Sports bra in the mail and put it on straight away – very comfortable so far although I’m yet to try running in it.

Mind you with how tired I seem to be at the moment I’m not sure when my motivation to get back into running will come. Still its very comfortable for my many walks getting bub to sleep and 3 year old to the park!!!

LifeMasters nursing insurance

For LifeMasters, Nothing Succeeds Like Success.

Here’s an update to a prior post about LifeMasters’ ongoing telephonically-based 11 county Florida disease management pilot program for dually eligible Medicaid beneficiaries with heart failure alone or with coronary artery disease and diabetes. As readers may recall, compared to a control group, there were enough savings to warrant CMS continuing the program. The bottom line intervention vs. control per member per month (PMPM) difference has not been reported yet, but we do know that most of the savings to date appeared to be associated with patients that were successfully engaged by the coach-nurses. As a result, LifeMasters has redoubled its efforts to reach even more patients and enroll enroll enroll. If successful, LifeMasters will deserve credit credit credit and CMS will undoubtedly look to expand the program.

According to a January 29 press release, the push to enroll now includes a ‘Health Network One’ (HN1) physician bounty or a ‘per-member per-month fee for each patient engaged in the program with incremental increases the longer the participant remains in the program.’ HN1 is described here as a Florida company that maintains provider networks for the insurance industry; the Disease Management Care Blog suspects these are private physician practices that rely on HN1 to handle the myriad details behind contracting and credentialing with health insurers. Getting some coin from LifeMasters is one of those details. This is classic win-win: the docs get income and greater buy-in with an otherwise distant vendor, while LifeMasters knows each enrolled patient – thanks to a physician referral - increases the likelihood of success for an already successful program.

The DMCB thinks this is important because of its prediction that disease management, the medical home, pay for performance, insurance benefit design and information technology will continue to evolve to a mutually supportive interlocking Unified Field (or maybe a Teilard de Chardin-esque ‘Omega Point’) of population-based care that collectively make up for the weaknesses of the individual components. We’re already witnessing interest in combined disease management – patient centered medical home approaches, benefit designs that lower barriers to self-care and the use of P4P to support the purchase of EHRs. This is one more example of this trend by a nimble disease management organization taking advantage of the synergies with other population-based care initiatives.

The DMCB suspects the next stage (unless it’s already arrived) will be three-way combinations, such as disease management organizations using P4P to support the medical home or consumer directed health plans that have first dollar coverage of services arranged by medical homes using an electronic record. Then will come 4 and then 5. Interested in knowing which will be the leading disease management vendor in the coming years? One way to do this is look for the program that successfully incorporates all of these concepts.

While LifeMasters and CMS deserve credit, this is ultimately research that is testing an model that is already underway in other settings. That being said, it's clear to most population program architects that, in an open-range, fee-for-service setting, it’s important to get the physicians involved. This is an attractive way to do that, especially if it’s combined with additional IT initiatives like this one and if the physician compensation is tiered and additive. The DMCB knows this because LifeMasters was kind enough to answer an email question about that from the DCMB.

One lingering question remains however: what happens to all that that pay? In an ideal setting, it should be plowed back into the office practice to support even better systems that result in even better performance for even greater pay leading to a virtuous cycle of escalating outcomes. The DMCB suspects that in large salaried physician practices, not all the money makes it to the docs' paychecks. Yet, instead of hiring more personnel or hardware to help garner better performance, the temptation is to use the performance-based revenue for something with an even better ROI - like an ultrasound machine or something. Not that the alternative of diverting all of the money directly to the physicians' pocket is any better. That could happen in an HN1 type of network.

We'll see. In the meantime, the DMCB recommends that disease management programs that get into the P4P arena follow the money.... carefully.

National Institute of General Medical Sciences

"The mission of the National Institute of General Medical Sciences (NIGMS) is to support research that increases understanding of life processes and lays the foundation for advances in disease diagnosis, treatment and prevention. NIGMS-funded researchers seek to answer important scientific questions in fields such as cell biology, biophysics, genetics, developmental biology, pharmacology, physiology, biological chemistry, biomedical technology, bioinformatics, computational biology, selected aspects of the behavioral sciences and specific cross-cutting clinical areas that affect multiple organ systems. To assure the vitality and continued productivity of the research enterprise, NIGMS also provides leadership in training the next generation of scientists as well as in developing and increasing the diversity of the scientific workforce." (from the NIGMS website)

The website has fact sheets about the Institute and biomedical research as well as news about their research, including online publications. There are resources for research funding and research training, too.

Health Education Resource Exchange

The Health Education Resource Exchange, H.E.R.E.., is an online clearinghouse of public health and health promotion materials and a whole lot more! It is a division of the State of Washington Health Department and has free posters, brochures, fact sheets, evidence-based health promotion projects and other professional resources. There is a listing of trainings and events in the Community Health field and free online community health courses. You can register as a colleague and get a bi-monthy newsletter and share your materials.

what if our healthcare system kept us healthy?

Rebecca Onie: Health services innovator Rebecca Onie is the founder of Health Leads, a program that connects patients to basic care and resources, such as food and housing, that are the root cause of many health problems.

Why you should listen to her:

In 1996, as a sophomore in college, Rebecca Onie had a realization: The health care system in the United States was not set up to diagnose nor treat the socioeconomic issues that lead to poor health, and that health care providers are not given tools to address basic problems like nutrition and housing.
So, while still a sophomore, she co-founded Health Leads, a program that assists low-income patients and their families to access food, heat, and other basic resources they need to be healthy. With the additional insight that college volunteers could be recruited and trained into an elite group just like a college sport team, she found the people and skills needed to produce such an audacious idea. Since then it has grown tremendously, and now operates in Baltimore, Boston, Chicago, New York, Providence, and Washington, DC, and in the last year assisted over 8,800 patients.
In 2009, Rebecca was awarded a MacArthur “Genius” Fellowship.
Photo: Courtesy of the John D. & Catherine T. MacArthur Foundation

Northwest Center for Public Health Practice

Check out the website for the Northwest Center for Public Health Practice. Their mission is to promote excellence in public health and the website offers information about News, Events, Training, Research, Evaluation of public health programs, and several publications concerning public health. The website is published by the University of Washington School of Public Health making it a credible resource for those interested in the field of Public Health.

How to make a nurse costume

How to make a nurse costume
This is how I made my cute nurse costume this year!
I used a button up short sleeved shirt from Suzy Shier, Ambercrombie and Fitch ruffled skirt and white bow flats.
And red duct tape.

http://www.tapes-direct.co.uk/bmz_cache/d/d98b5aef849a64a21bd644108cf5dc92.image.280x280.jpg

Everything you see here was either made by hand or items I already owned.
This costume was very simple to make. It took me a while because I did not have a design in mind and was just playing around. For everyone else, I recommend to refer to pictures of existing nurse costumes.

This is 1/3 of the sexy nurse costume.
Those sideways 'Ls' are supposed to be pockets, BTW.
Red tape circling the end of the sleeves and a single universal medical red cross on the chest.
Looks nice and simple yet still creative!

These 'buttons' are actually tiny cut out hearts.
They took me forever to cut them out. This part actually took me the longest to do!

A shot of the backside.
It's blank except for a tiny red cross near the lower back.

The A&F mini skirt.
Very very simple design, two medium sized medical crosses on the left and right hip.

This is a photograph of the back of the skirt.
Again, there is a tiny cross located near the bottom.
Seems to be a recurring theme I guess.

My shoes that I'm going to wear!
Yes, I am only wearing one sock at the moment- the other one got wet.

The nursing cap headband that I made.
My mom says it looks adorable but she may have been lying to save my happiness.
I folded a piece of white paper in half, cut out the pattern that I wanted and used red tape to seal off all the edges, leaving the bottom. Afterwards I slid a white headband into the slot provided.
Easy as A-B-C.

Every nurse needs a large white bag to hold all her important items in!
Accessorized with another cross at a corner.
I wish I had a photo of myself wearing this outfit. Unfortunately, bad hair day all this week and classic laziness deterred me.
I'll have photos either tomorrow (Frightnight) or next week.

Accessories that I did not have but would have made my costume better would be:
- stethoscope (looped casually around the neck would look so sexy!)
- white stockings (going all the way up to mid-thigh)
- large toy thermometer or needle (To 'care' for the patient)
- medical chart
Other variations of nurse costumes:
To be a scary nurse instead, add some fake blood and mess up your hair. Add some white face powder and heavy eyeliner and you're set to go scare little kids.

A modern nurse wears scrubs (any colour and pattern), a stethoscope, hair in a ponytail and holds a medical chart. You may easily be confused with a doctor or an intern, so for easy reference, make a name tag that says 'NURSE namehere'.

https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJlj-tO_c15PY-4q7XcfjXg1CpvWp_6KJejeV2GPlPTbEiObH49iTujN7rv50yrB9DxCpnjXsHaUmtR-HqlmOxGDdXOY-S0PC43_pAQQupfXG9EKulxCpL-PedW0o7h6sXGUJTXtrueyXq/s400/nurse+uniform+modern.jpg

For a joker nurse. Add a short curly red wig, traditional surgical mask and the trademark joker makeup.

http://trylobyte.files.wordpress.com/2008/04/joker_nurse.jpg

Silent hill nurse: I have absolutely no idea where to start with this. It's an amazing costume but I would expect it to be insanely hard to make and hard to breath and see in it.
There are plenty of tutorials on the internet so check those out.

Cincinnati Insurance Companies (LOGO)

The Cincinnati Financial Corporation is an insurance company in Cincinnati, Ohio, which uses the brand name "Cincinnati Insurance Companies". It recently revealed a new logo, which replaces its image of Cincinatti skylines with an image of a bridge.

The typography is also altered from an bold all-caps Times typeface to a thin typeface from the Eras family, also in all-caps. The company has previously used the Eras family in its communciation.

The new logo was reportedly revealed last Friday, April 29, at the company's annual meeting. A press release issued yesterday, May 2, offered the following explanation:

A new company logo we introduced at our meeting celebrates the momentum we are building by expanding our operations, increasing efficiencies, stepping up our expertise and recommitting to ethical values. As we start the next chapter of our 60-year history, we are committed to improve on our traditional strengths and create new ones that enhance our relationships with our agency customers and add value for shareholders."