Communication with Pharmacy

Pharmacy is asking the nursing staff to help with the number of orders scanned at certain times of the day - around lunch and evening shift change (1900). They are getting disproportionate amounts of orders scanned at these times. Of course, this directly correlates to when the physicians are writing the said orders. They would like us to help out by scanning orders as quickly as possible after they are written, instead of letting the chart sit on the "to do" rack and waiting for the UC to take the orders off.

Pharmacy is also getting a high number of phone calls to check on the status of meds. They would rather that we save the phone calls for emergent or stat needs. Instead of using the phone, they are asking us to write a message on a paper and scan it like you would an order. This way it comes up on their Pyxis cue and can be addressed.

Wound Care RN coverage

Julie, one of our wound care nurses is out on maternity leave until sometime in October. In the meantime, Cris RN will be doing wound care rounds on Mondays. Tuesdays through Fridays, the flow nurses Betsy and Laura will be taking messages for wound care. This means that they may be at the Foothills campus some evenings. During those times, they will not be able to do admissions on Broadway. You can still page the flow nurses during normal hours; they will call you back to let you know if they are on campus.

Clinical Round-Robin, Hands-on Practice

Sorry for the late notice on this one!

(Tomorrow) July 23
7a-3p
Foothills Leo Hill Conference Center

Topics:

• Mediport Access Skills
• New Central Line dressing change kit
• Drawing blood cultures
• Stat Lock practice
• PCEA pumps
• Feeding tube tips, preventing clogs
• Diabetes boxes, Glucometer practice

A series of clinical "round robins" will be held monthly. This is a great chance to update your competencies. Look for future schedules here, Mox/email, and on the unit.

New Universal Protocol Policies

Universal Protocol = Verification of correct patient/site/side, etc.

New policies for Universal Protocol can be found on Meditech. This policy applies to invasive procedures (central line placement, biopsies, chest tubes, etc) or any time procedural sedation is used. Site marking is done by the physician on any procedure where laterality is involved and should be done while the patient is not sedated.

Joint Commission Survey Underway

The Joint Commission Survey began this morning. Please take this opportunity to review your Joint Commission Pocket Guide. The unit is looking great right now, please pitch in where you can to keep it that way.

Don't forget: Pump In, Pump Out!

TJC (JCAHO) expected soon!

The hospital is expecting surveyors from The Joint Commission starting Monday, June 22 or the following week of June 29. The unit is looking "survey ready", so please do your part to keep it in tip-top shape. Now would also be a good time to review your red booklets.

N95 mask fittings/PPD walk-in clinics

Don't forget that having your mask fit test and PPD completed in a timely manner is part of your job requirements. If you're due or past-due for these tests, you can come to one of these clinics without an appointment:

Monday, June 22
Foothills Chairman's Room
12-1:30 pm

Wednesday, June 24
Alcove outside Gene Wilson
12:30-2:30 pm

Diabetes Teaching Supply Kit

Beginning Monday, June 22, all nursing units will be stocked with a "ready to go" Diabetes Supply Boxes. Wahoo! Inside each box, you will find tote bags filled with items that your may need for education.

The contents are available in English and Spanish, and they will include:

• Educational video
• Comprehensive diabetes reference guide
• Meal planning guide and carb counter
• Pedometer
• Glucometer and instructions
• Schedule of support groups and meetings

Patients may take these tote bags and their contents home. They are free of charge for patients who begin their diabetes education with us. The boxes are restocked by the flow nurses.

If you have any questions, please contact Emily W. @ ext. 2379.

O2 tanks

Storage for oxygen cylinders is in the respiratory closet. If you have an O2 tank that is low or empty and needs replacement, purchasing will only switch it out if the tank is in the storage area. Tanks that are in wheeled carriers in the hallways and patient rooms will not be switched out because purchasing considers them "in use".

Patient belongings

Patient belongings should be charted and described specifically upon admission. For instance, instead of simply documenting "clothes", write "blue jeans", "wool sweater", "fur coat", etc. Do the same with jewelery, but you need to be general with this as we cannot determine what is a diamond or 14 karat gold. An example would be "ring with white stone", "gold pendant necklace", etc. Specific documentation can protect the hospital from litigation if a patient claims that the hospital misplaced their fur coat. If you have any questions, please see Peggy.

Assignments with 4-5 pts in a shift

If you are assigned to 4-5 pts for a shift, write your name and date on a sheet found in the purple binder (you know, the "old schedule" binder). You will find this sheet behind the LOL list.

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!