CLABSI
Your patient transferred from a hospital with a PICC line in place. Who should you inform to ensure this line is placed correctly and working well (and for monitoring)?
IV therapy
What is the best way to prevent CAUTIs and CLABSIs?
Remove lines when not needing, consider alternatives and not use lines in the first place.
You come on shift and find your new patient has fallen. What do you need to do?
Assess patient for injuries, notify provider, fill out IRIS and post fall debrief
You are cleaning your patient and you find a new coccyx wound. What should you do?
Notify provider, take pictures for chart, add LDA, IRIS.
Your patient is having diarrhea and finished golytely yesterday. Would it be appropriate to test for C. diff today?
Your patient has a leftover PICC line from the ICU, 3 PIVs only has one IV antibiotic every 24 hours ordered. What should you do?
Remove PICC, remove PIVs so pt has minimally necessary access to prevent harm.
The physician orders a urine culture for a suspected UTI on your patient with a foley. What are the steps you will take to properly collect this?
Request order to change catheter, collect culture from new catheter.
Your patient slips on a blanket and falls. What type of fall is this?
Accidental.
When should you complete the 2 RN skin verification?
Within 12 hours of admit and at handoff/transfer from another unit.
You are collecting a stool sample for the C. diff test and you see that it is a bristol type 4. What should you do?
Contact the provider and let them know; no formed stools should be sent to lab. Pt may not need C. diff testing.
You find that your patient’s PICC line dressing is falling off. What should you do?
Change the dressing, or request IV therapy to change the dressing
Your patient just downgraded from the ICU to med/surg. They arrived with a foley for “critical care status requiring hourly output”. What should you do?
Remove catheter as indication is no longer met.
Your patient has been having low blood pressure. You assist this patient to stand and they pass out. What type of fall is this?
Anticipated physiological.
If a wound is present, how often should pictures be taken for the chart?
Every 7 days and with any changes.
Do you need to send a C. diff Ticket to Test down with the stool sample if you know that the testing criteria is met?
Yes, all C. diff samples sent to the lab need to be accompanied by a Ticket to Test.
How often should a central line dressing be changed?
Every 7 days and when loose/soiled.
True/false: a urinary catheter should be inserted when you have a patient who is incontinent of urine in order to keep them dry.
False.
Your patient insists on going to the bathroom alone though he is a high fall risk. How can you keep him safe while allowing him to have privacy?
Stand within arms reach of him, allow him to sit and stand outside the door and re-enter after he is finished.
Describe the process of ordering a specialty mattress.
Use bed algorithm if pt is at high risk for skin breakdown, ensure there is an order in the chart if pt need surface other than waffle, use bed ordering sheet to order.
Why is it bad to test people for c. diff if they are not having diarrhea?
Many people are colonized with C. diff and not actively infected, this can cause false positive results and lead to inappropriate antibiotic use.
Your patient needs IV antibiotics for the next 3 days. What type of line is best for this patient?
PIV.
How long after the patient falls should the post-fall debrief be completed?
Within 15 minutes.
What should you do if your patient is refusing to be turned?
Educate the patient on the importance, escalate to the charge nurse, show pictures in the skin book, document .turnrefusal in note, let the provider know
Name a medication that your patient is taking that could cause them not to meet criteria for c. diff testing.
Any laxative is an acceptable answer.