Guidelines for H1N1 flu

The CO Dept. of Health has issued updated guidelines for caring for pts with suspected or confirmed H1N1 flu.

These pts can be placed in Droplet Precautions (not negative pressure room) with the use of standard precautions UNLESS a procedure is being done that would cause secretions to be aerosolized (intubation, bronchoscopy, nebulizer treatments). If aerosolization may occur, staff should wear the N95 mask.

3W MDRO Precautions

As stated in an earlier post, 3W will be implementing formal isolation procedures for our pts with infections requiring protective isolation. May 18th is the day that these procedures will become official, so now is a good time to familiarize yourself with what you need to do.

• Isolation carts: The contents of the carts have all been standardized. A contents list is secured to the top of all carts. In the list you will find the ordering number for each item, should you need to replenish the stock. The staff discharging the pt is responsible for restocking the cart.
• Nurse servers: These must be closed and secured with "caution" tape whenever a pt is placed in isolation. Two old IV trays have been converted to stock items that are normally found in the nurse server. These supplies are additionally bagged in biohazard bags. Only bring into the room whatever supplies you actually need. Remember that everything that comes out of the room must be cleaned or disposed.
• Linen bags: You may still use these as usual. Clean linen should only be brought into the room on an as-needed basis.
• Room equipment: If a piece of equipment is not needed, remove it from the room before the pt arrives. Equipment that can be removed from the room (such as IV poles) will be tagged with the "Clean/In Use" tag. Items that stay in the room are not tagged. The person removing the equipment from the room is the one responsible for cleaning it. Keep walkers in the room until discharge; when they are no longer needed, clean them and store in the PT office. O2 tanks will be tagged; clean appropriately when removing from an isolation room. Equipment that is tagged and can be removed from the room will stay with the pt for their entire hospitalization.
• Tergo wipes: Keep an eye on these. If you find any with mold growing on them, place them in a garbage bag and place outside of Melissa's office. We should be checking the bin of Tergo wipes once a week or so to monitor for mold. Alert Melissa if you have any issues.

Please contact Melissa if you have any questions. More information will be coming soon!

Showers for OHS pts

Per Peggy, OT is not required to do the first shower with our open heart pts. It is a good opportunity for the primary RN to assess the pt and begin teaching. RNs should check to make sure that all dressings are removed, PICCS/peripheral IVs are covered, and pacer wires are insulated before the shower. Any moisture at invasive sites promotes to growth of bacteria. Peggy is working on a new post-chest tube-removal dressing that would allow the patient to shower the same day as chest tub-removal. For now, pts must wait 24 hours after the tubes are removed before showering.

Need a good laugh?

Check out this "educational" video about AV node blocks..thanks to Michelle Mo for the link!