NRS 440VN Week 4 Discussion 2

 Discuss how the CMS reimbursement rules for never events required a shift in the patient care delivery model in inpatient facilities.

The CMS stated that when patient goes to the hospital for treatment, patient should not expect to leave with additional injuries, infections, or serious conditions that occur during the course of stay. The complications may not be avoidable, but the CMS found in often times, patients suffer from injuries or illnesses that could have been prevented if the hospital had taken proper precautions. There are three areas commonly occur which the CMS will deny reimbursement:

1. Case Management- Stage III- IV pressure ulcers, air embolism, poor control of blood sugar levels, fracture, burns, joint dislocations, and other injuries occurring from falls or other trauma suffered while an inpatient.

2. Surgical Events– Surgery on wrong body part, on the wrong patient, wrong surgery on the patient, retention of a foreign object, such as a sponge or needle, inadvertently left in a patient after surgery, surgical site infection such as a coronary artery bypass graft, bariatric surgery, orthopedic procedures, deep vein thrombosis or pulmonary embolism following certain orthopedic procedures.

3. Medical Products and Devices– transfusion of wrong blood type, catheter associated urinary tract infection, and vascular catheter associated infections (O’Rourke & Hershey, 2009).

These complications could be avoidable if we take more times while caring for patient. For example with fall incident or pressure ulcer, the nurse may not prevent some patients from falling, but equipped with fall risk assessment or pressure risk assessment to where early intervention can take place can prevent the incident or injury from occurring . These two problems happen more in the acute care setting because of many high risk medication and the sickness or the weakness may the patients have. There is no wining with the “ never events” incident, but awareness can prevent patient for suffering.

O’Rourke, P., & Hershey, K. (2009). Never-Event Implications. Retrieved from