Essay Sample on Applying Regulations in Varying Care Settings

Introduction

The regulations applied in healthcare settings are different depending on the settings. The differences are as a result of the needs and operations of these settings and they determine the staffing requirements, release, and sharing of the patients' records, the rights of the patients, the administrative structures used and the other factors related to the safety in the care environment. The differences observed are also related to the expected results and the quality of healthcare expected from these departments or settings. The Intensive Care Units (ICU) are a critical part of the healthcare centers because of the services they offer, the level of accuracy and quality expected and the possible outcomes from them. Similarly, the emergency departments play a critical role in the outcomes of the patients and they set the pace for the treatment process. The two settings have different regulations that suit their operations.

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Staffing Requirements

The average number of people who get admitted to the ICU in the United States is about four million per year. Out of that number, about half a million of them die. One of the factors associated with the high mortality rate in the ICU is staffing, whereby some of the hospitals have few staff members qualified to work in them. In some areas, the ICU has many employees but some are not qualified and their performance is low. The staff members in the ICU with inadequate employees are likely to get fatigued easily. The fatigue, burnout and secondary traumatic stress are among the main reasons that lead to poor quality services and outcomes in the ICU (van Mol, Kompanje, Benoit, Bakker & Nijkamp, 2015). The required staffing ratio is 1:2, which means that one nurse should be allocated a maximum of two patients. In the emergency room, the ratio is slightly different. It is from 1:4 and this is because of the differences in the requirements and activities of the two settings. The similarity is that staffing is supposed to be adequate and the difference is the ratio required.

The release of Patient Records

The patient records in all departments require a keen analysis and confidentiality to ensure the rights of the patients. The coverage and participation are different in the ICU and emergency settings because of the way the two settings operate. The law requires that all medical records should be retained by the hospitals for at least six years since the last time a patient visited the hospital. The release of the medical records in the emergency rooms is critical to the treatment processes in the future. For example, for people with drug-related issues, their records are used to determine their treatment procedures in the emergency department (Shehab et al., 2016). The difference between the releases of these records is that in the emergency department, the records are released to the rest of the departments for action once the condition of the patient stabilizes. However, in the ICU, the records are held with the nurses until the patient dies or improves and leaves the ICU.

Patient Rights

The rights of the patients are different in different settings and mostly because of the conditions of the patients in the care settings. For example, in the emergency care settings, the participation and coverage of the rights involve the patients and the nurses in most cases, while in the ICU, most of the patients are not on a position to choose or realize their rights. In the emergency department, the patients have three major rights and these are the right to be treated with privacy, the right to privacy and the right to information and choice. The difference with the ICU is that even if the patient is entitled to these rights, they may be too sick to make choices and determine when their privacy is violated. Therefore, the ICU relies heavily on the ethical standards of the staff. According to Emanuel (2018), the ethical standards in the ICU settings in the United States are used to ensure the rights of the patients are not violated. The nurses and doctors are required to ensure the rights are observed in all care settings.

Administrative Structures

The administrative structure of the healthcare settings determines the services delivery success. In the emergency settings, the administrative tools and techniques used are aimed at increasing the speed and accuracy of the services and making the right referrals. The administration required is that of a quick response to the challenges that affect the care setting. For the ICU setting, the administrative structure required is aimed at increased care, accurate medication, and follow-up. According to a study done in Beth Israel Deaconess Medical Center in Boston, the organizational structure of the ICU affects the quality of services offered (Boone et al., 2016). The similarity between the two settings is that they require participative and accurate administration.

Other Aspects

The other aspects related to the two care settings is the availability of facilities in different care settings. The type of facilities available in the setting determines the effectiveness of the services offered and can lead to high or low mortality rates (Mathur et al., 2017). The emergency care settings require different facilities from the ICU because of the activities undertaken. For example, the life support machines are in the ICU and not in the emergency rooms. In conclusion, the care setting determines the coverage and participatory features and the way services are delivered.

References

Boone, M. D., Massa, J., Mueller, A., Jinadasa, S. P., Lee, J., Kothari, R., ... & Hacker, M. R. (2016). The organizational structure of an intensive care unit influences the treatment of hypotension among critically ill patients: A retrospective cohort study. Journal of critical care, 33, 14-18.

Emanuel, E. J. (2018). The Status of End-of-Life Care in the United States: The Glass Is Half Full. Jama, 320(3), 239-241.

Mathur, A. K., Chakrabarti, A. K., Mellinger, J. L., Volk, M. L., Day, R., Singer, A. L., ... & Moss, A. A. (2017). Hospital resource intensity and cirrhosis mortality in the United States. World journal of gastroenterology, 23(10), 1857.

Shehab, N., Lovegrove, M. C., Geller, A. I., Rose, K. O., Weidle, N. J., & Budnitz, D. S. (2016). US emergency department visits for outpatient adverse drug events, 2013-2014. Jama, 316(20), 2115-2125.

van Mol, M. M., Kompanje, E. J., Benoit, D. D., Bakker, J., & Nijkamp, M. D. (2015). The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: a systematic review. PloS one, 10(8), e0136955.