Every healthcare organization/hospital accepting payment for Medicare and Medicaid patients is required to meet certain Federal standards called “Conditions of Participation” (CoPs).
These Federal requirements are promulgated by the Centers for Medicare and Medicaid to improve quality and protect the health and safety of patients. Compliance is based on surveys conducted by state agencies on behalf of the CMS. Conditions of Participation are regulatory standards hospitals agree to follow as a condition for receiving federal funding through the Medicare program.
Under an agreement with CMS, State healthcare licensure agencies conduct surveys of hospitals and enforce compliance with CoPs and ensure that Conditions of Participation are being practiced. Hospitals and other healthcare facilities are subject to random onsite reviews. Unannounced surveys can result from patient or public complaints or inquiries. Healthcare Security is an important element for the new 2006 Conditions of Participation.
CONDITIONS of PARTICIPATION
Department of Health & Human Services
Centers for Medicare & Medicaid Services
(Healthcare Security)
____________________________________________
A-0038
Title 42CFR, Volume 3 – §482.13 Condition of Participation: Patients’ Rights
A hospital must protect and promote each patient’s rights
Interpretive Guidelines §482.13
These requirements apply to all Medicare or Medicaid participating hospitals including short-term, acute care, surgical, specialty, psychiatric, rehabilitation, long-term, childrens’ and cancer, whether or not they are accredited. This rule does not apply to critical access hospitals. (See Social Security Act (the Act) §1861(e)).
These requirements, as well as the other Conditions of Participation in 42 CFR §482, apply to all parts and locations (outpatient services, provider-based entities, inpatient services) of the Medicare participating hospital.
____________________________________________
A-0057
Title 42, Volume 3 CFR – §482.13(c)(2) The patient has the right to receive care in a safe setting.
Interpretive Guidelines for §482.13(c)(2)
The intention of this requirement is to specify that each patient receives care in an environment that a reasonable person would consider to be safe. For example, hospital staff should follow current standards of practice for patient environmental safety, infection control and security. The hospital must protect vulnerable patients, including newborns and children. Additionally, this standard is intended to provide protection for the patient’s emotional health and safety as well as his/her physical safety. Respect, dignity and comfort would be components of an emotionally safe environment.
Survey Procedures §482.13(c)(2)
• Review and analyze patient and staff incident and accident reports to identify any incidents or patterns of incidents concerning a safe environment. Expand your review if you suspect a problem with safe environment in the hospitals.
• Review QAPI, safety, infection control and security (or the committee that deals with security issues) committee minutes and reports to determine if the hospital is identifying problems, evaluating those problems and taking steps to ensure a safe patient environment.
• Observe the environment where care and treatment are provided.
• Observe and interview staff at units where infants and children are inpatients. Are appropriate security protections (such as alarms, arm banding systems, etc.) in place? Are they functioning?
• Review policy and procedures on what the facility does to curtail unwanted visitors or contaminated materials.
• Access the hospital’s security efforts to protect vulnerable patients including newborns and children. Is the hospital providing appropriate security to protect patients? Are appropriate security mechanisms in place and being followed to protect patients?
Exceptions:
The use of handcuffs or other restrictive devices applied by law enforcement officials who are not employed by or contracted by the hospital is for custody, detention, and public safety reasons, and is not involved in the provision of health care. Therefore, the use of restrictive devices applied by and monitored by law enforcement officers who are not employed or contracted by the hospital, and who maintain custody and direct supervision of their prisoner are not governed by §482.13(f)(l-3). The individual may be the law enforcement officer’s prisoner but he/she is also the hospital’s patient. The hospital is still responsible for providing safe and appropriate care to their patient. The condition of the patient must be continually assessed, monitored and reevaluate.
JCAHO – 2006
(Healthcare Security)
____________________________________________
The Joint Commission on Accreditation of Healthcare Organizations evaluates and accredits more than 18,000 healthcare organizations and programs throughout the United States. Hospitals aggressively seek Joint Commission accreditation to meet Medicare certification and licensure requirements. Accreditation is also a condition of reimbursement for many insurers and other payers. In addition, JCAHO Accreditation reduces the hospital’s liability insurance premiums. Beginning in 2006 JCAHO will conduct all surveys without prior notice.
The Joint Commission has accredited hospitals for more than 50 years and today accredits over 80 percent of the nation’s hospitals. The Centers for Medicaid & Medicare Services (CMS) have required JCAHO accreditation by US hospitals since 1965 as a ‘Condition of Participation’ requirement in order for them to receive Medicaid and Medicare reimbursements.
The Joint Commission and Healthcare Security
The Joint Commission’s Standards address the hospital’s performance in specific areas, and specify requirements to insure that patients are provided a safe and secure environment. 2006 Environment of Care© requirements include, but are not limited to the following:
• Development and maintenance of a written Security Management Plan to include an Emergency Management Plan.
• Conduct an annual Risk Assessment that evaluates the potential adverse impact of the external environment on the security of patients, staff, and others coming to the facility.
• Use the risks identified to select and implement procedures and controls to achieve the lowest potential for adverse impact on security.
• Identify, as appropriate, patients, staff and other people entering the facility.
• Access Control / Physical Protection – control access to and egress from security sensitive areas, as determined by the organization.
• Mitigate Violence in the Emergency Department and other locations.
• Education and Training – staff, licensed practitioners, and volunteers have the knowledge and skills necessary to perform their responsibilities within the environment.
• Develop and implement a proactive infant abduction prevention plan.
• Include information on visitor/provider identification as well as identification of potential abductors/abduction situations (during staff orientation and in-service curriculum programs).
• Enhance parent education concerning abduction risks and parent responsibility for reducing risk and then assess the parents’ level of understanding.
• Attach secure identically numbered bands to the baby (wrist and ankle bands), mother, and father or significant other immediately after birth.
• Footprint the baby, take a color photograph of the baby and record the baby’s physical examination within two hours of birth.
• Require staff to wear up-to-date, conspicuous, color photograph identification badges.
• Discontinue publication of birth notices in local newspapers.
• Consider options for controlling access to nursery/postpartum unit such as swipe-card locks, keypad locks, entry point alarms or video surveillance (any locking systems must comply with fire codes).
• Consider implementing an infant security tag or abduction alarm system.
Material in this brochure provided to Accutech-ICS (www.Accutech-ICS.com) by Security Assessments International, Inc., www.saione.com
Disclaimer
The information provided by Accutech-ICS.com and SAI is in accordance with our understanding of current JCAHO and CMS Regulations. It is intended for educational purposes only and should not be considered ‘legal’ advice. Please consult with your legal counsel or Compliance Officer for clarification of laws and rules related to your State when applicable.
Accutect-ICS.com and SAI are not affiliated with the Joint Commission on Accreditation of Healthcare Organizations.
Accutech-ICS.com and SAI – ©January, 2006
About The Author
Karl Radke is the director of sales and marketing at Innovative Control Systems, Inc (ICS) headquartered in Franklin, Wisconsin. Karl has been vital to the marketing and development of the Accutech product line. Accutech is recognized as the market leader in infant and pediatric security while maintaining a strong role in long-term care and assisted living markets.
For more information about Accutech, visit http://www.Accutech-ICS.com or e-mail Karl at karlr@accutech-ics.com.
Depression during pregnancy refers to the stress or strain which is caused due to the increase of hormone level in a woman’s body resulting in mood swings , in particular the two main female hormones-estrogen and progesterone causemood swings during pregnancy. This is not a disease but a normal problem which can be treated through extra love, care and protection.
Is depression more common in women than in men?
Yes. Women are twice as likely as men to experience depression. The reason for this is unknown, but changes in a woman’s hormone levels may be related to depression.
What are the symptoms of depression in women during pregnancy ?
If you’re depressed, you may have some of these symptoms nearly every day, all day, for 2 weeks or longer:
- Feeling sad, hopeless and having frequent crying spells
- Feeling guilty, helpless or worthless
- Thinking about death or suicide
- Sleeping too much, or having problems sleeping
- Loss of appetite and unintended weight loss or gain
- Feeling very tired all the time
- Having trouble paying attention and making decisions
- Having aches and pains that don’t get better with treatment
- Feeling restless, irritated and easily annoyed
-
What causes depression in women during pregnancy ?
Depression seems to be related to a chemical imbalance in the brain that makes it hard for the cells to communicate with one another for example the improper level of serotonin in the brain can cause mood swings. Depression can also be hereditary, which means it runs in families.
In the days following the birth of a baby, it is common for some mothers to have mood swings. They may feel a little depressed, have a hard time concentrating, lose their appetite or find that they can’t sleep well even when the baby is asleep.
How is depression during pregnancy is treated?
Depression can be treated with counseling, medicine or both. It’s also important to take good care of yourself, to exercise regularly and to eat healthy foods. See the health tips below. Counseling alone may help if the depression isn’t severe.
Some do’s and don’ts when you’re depressed
- Always ensure to talk with your loved ones, friends and family to avoid the feeling of isolation. Always seek the advice from your family doctor.
- Exercise balances the hormone and avoid mood swings. Example the level of serotonin in the brain can cause mood swings and can be balanced by doing yoga, aerobics etc.,
- Remember not to blame yourself for your depression. You didn’t cause it.
- Suppress the discouraged feeling by keeping positive sign boards and try to do meditation to clear your depression.
- Do eat balanced meals and healthy food.
- Do get enough sleep. Some women sleep more during depression.
- Do take your medicine and/or go to counseling as often as your doctor tells you to. Avoid self medication.
Does depression affect my unborn baby?
Yes. It has been proved by many research that depression can affect the growth of the fetus. Mothers-to-be who are depressed during pregnancy are more likely to have babies sleep problem during their 18th month says O’Connor a research expert.
In his recent research, O’Connor says, follow others’ research showing that mothers who report being stressed during pregnancy have children with higher rates of behavioral problems, as well as hyperactivity and anxiety.
Revathi Sankaran, a specialist in Prenatal and infant education is the founder of Little Gems – Promotors of Infant’s concentration of mind a brain stimulation center for kids since 1993. For more details on how to make your child a genius while in womb contact Little Gems Prenatal and Infant Education
Article Source:
http://EzineArticles.com/?expert=Revathi_Sankaran
Louisiana begs for more booms as oil slick laps coastal islands – Yahoo! News
HOPEDALE, Louisiana (AFP) –
Louisiana begged for more protective booms and urged the federal government not to repeat the mistakes of Hurricane Katrina Friday as a massive oil slick lapped coastal islands.
More than two weeks after a BP-leased rig sank spectacularly 50 miles offshore and started hemorrhaging an estimated 200,000 gallons of oil a day into the Gulf of Mexico on April 22, vast swaths of the US coast remain unprotected.
High winds and rough seas bear some of the blame, but Governor Bobby Jindal said the problem now is a lack of the resources needed to avert disaster.
“We need more booms to keep this oil out of our fragile wetlands,” Jindal said at a press conference in the remote port of Hopedale.
“It's so important to have those first lines of defense in place,” he said.
“It'll be so much harder to clean up this oil if it's allowed to come into the inside and the backside of these wetlands.”
Fishermen watching their livelihoods get washed away by a toxic soup are anxious to get their boats out the docks and help in efforts to skim the oil off the surface and lay out protective booms.
While a lucky few have gone out to help, most sit around waiting for the phone to ring.
Federal officials say they have a stockpile of 1.3 million feet of boom ready to be deployed across the Gulf Coast.
They shipped 20,000 feet to Hopedale on Friday, bringing the parish's total to 60,000 feet.
Local officials say they need at least another 240,000 feet of hard and absorbent boom to offer the “very minimal protection” to the parish's 120 miles of coastal wetlands.
And the oil sheen has already entered their waters.
“We cannot afford to let this turn into another catastrophe for St. Bernard parish,” said parish president Craig Taffar.
“It's a community that is just getting back on its feet after Hurricane Katrina.”
Taffar acknowledged that fighting the oil was a monumental task and that it will be impossible to protect every inch of his parish.
But he said the psychological impact of suffering through another disaster where the government failed to apply the proper resources is “unforgiveable.”
“I'm not sure that their mental and psychological well-being will recover as well from this as we did from Katrina,” he said. “You can only take so many blows before you fall down.”
Taffer – whose parish stretches from this isolated port to the edge of the Lower Ninth Ward in New Orleans – said the current situation does not approach the complete failure of government after Hurricane Katrina struck on August 29, 2005.
Tens of thousands of people were stranded for days without food or water – some on their roofs, others at the Superdome stadium or on freeway overpasses – after a massive storm surge wiped out coastal towns and smashed through poorly-maintained levees.
The scars are still visible across the parish where abandoned homes rot in the hot sun, the spray painted markers left by search and rescue crews a stark reminder of those who died when the water rushed in.
This looming ecological and economic disaster evokes painful parallels to those chaotic days when desperate people were left to fend for themselves, Taffar said.
“It certainly has remnants of feeling helpless and having agencies and individuals in higher levels of authority controlling our destiny, and that is frightening,” he said.
“We have our residents and fishermen here – they're standing here begging to be utilized to protect their own livelihood and the resources aren't here.”
BP is financially responsible for all cleanup efforts, which are also being supervised by the US Coast Guard and a host of other agencies.
Some 10,000 people and about 270 boats have been deployed to the Gulf Coast to help combat the ever-growing slick.
There is no reason why more cannot get involved, Taffer said, or why resources are being spread out across the coast when Louisiana faces an “immediate threat.”
“If there's boom headed to Alabama or Florida where there is not a direct threat we are asking the Coast Guard to bring them here,” he said.
“We need the resources to protect our wetlands. We need the resources to protect our way of life. We need the resources to protect a culture- and a history-rich parish.”
