Sunday, August 30, 2009

Wound Care RN hours

Wound Care RN hours while Julie is on maternity leave until October are as follows:

Monday 8am-4pm, pager will be carried by Cris
Tuesday, Wed., Thurs, Fri, 2pm-10:30pm, the flow nurses Betsy and Laura will take messages from the Would Care voice mail and see patients for wound care consults. They can also be reached on their pagers.

Wednesday, July 22, 2009

Pneumococcal and Flu Vaccines for pts

Effective July 13, there is a new procedure for administering Flu and Pneumococcal vaccines.

  • On the back of the Home Medication Reconciliation Form (I've also seen it as a form on it's own), you will find a Pneumovax/Flu assessment and consent form. Pneumovax is given year round, and seasonal flu vaccines are given Oct. thru Mar. only. If the patient has been immunized for both, then ignore this form.
  • The nurse or pharmacist may assess the patient and order the vaccine(s) without the physician writing a specific order.
  • Give the patient the vaccine information sheet for Pneumococcal PPSV23 or Influenza. Obtain their consent signature on the vaccine assessment form. Scan the order to pharmacy. The pneumococcal vaccine will be stored in the Pyxis refrigerator. I'm not sure about the influenza vaccine.
  • Document the administration of the vaccine on the one-time order sheet, as well as on the front of the Home Medication Reconciliation form.

Insulin sliding scales

The hospital has stopped using the "SSICU" tight glycemic control sliding scale per the recommendations of the American Diabetes Association. We will now only use the sliding scale with a BS goal of 70-180 (correctional insulin starts at 150).

Nutrition Care Manual

Did you know that we have a great dietary information resource, right on the computers? Click on the "BCH Web Applications" icon on any unit computer. In the list of applications, you will find the "Nutrition Care Manual". It has information about the diets and how they relate to disease processes. You can navigate the manual via tabs at the top, or by searching.

The hospital and surrounding clinics have 2 subscriptions to this manual. If you find yourself "locked out", it may be due to too many people trying to access it at once. Just try again in a few minutes.

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.

Monday, July 13, 2009

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!

Sunday, June 21, 2009

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.