Quality and Safety
Pressure injury prevention measures to take if a patient has a braden scale of less than 18 (list at least 3)
What is turn at least every 2 hours, apply mepilex sacral dressing (if not incontinent), apply bilateral mepilex heel dressings, off load with z flex boots
What imaging method needs to be done to confirm feeding tube placement before use of the tube?
What is an XRAY?
This needs to be done within 10 minutes of a patient reporting chest pain.
What is get an EKG?
According to our current falls policy, a patient with a Morse score of blank or higher is consider a high fall risk
What is 45
Your patient has new facial droop and is drooling, you activate inpatient stroke activation by dialing this number
What is 7-7111
A patient who is deemed "High Fall Risk" needs what precautions in place?
You are performing a BMAT assessment on a patient. They are able to stretch and point each leg/foot, but are unable to stand with good balance for 5 seconds. What BMAT level are they and what equipment might you use to mobilize them?
What is level 2. What is a sit to stand, hoyer lift, etc.
Which lab value do we trend when a patient is on a heparin drip to determine rate of infusion?
What is a PTT?
If your patient were to fall, what 4 documentation items must be completed?
What are a Fall Swarm, SafetyNet, objective nursing note, and Morse fall score reassessment
ERAS principles is surgical patients need to do this within 4-6 hours of arriving on the unit
What is ambulation (early ambulation). Ambulation after surgery helps patients breathe better, helps with digestion, and prevents blood clots)
When admitting a new patient to the floor, 2 people are required to do what?
What is 2 person skin check.
The provider orders a chest tube set up to continuous suction: 20cm. What does the wall suction need to be set to achieve this?
What is -80mmHg (on wall)
How can a chest tube drainage system by converted from suction to gravity?
What is disconnect the suction tubing from the drainage system.
You are doing an assessment on a patient and discover the patient has a new pressure injury. What 4 things must be done?
What are consult wound care, add wound to WLDAs, complete HAPI swarm, and enter a safety net.
It's after 7 PM, where would I go to find out which specialty provider is on call for the night?
What is QGenda on MyIntermountain?
What type of cleaning treatment is required for patients with a central line and how often must this be completed?
What is a daily full body CHG treatment after a hygiene bath.
List at least 4 neutropenic precaution interventions.
What are:
1. Place a neutropenic precaution sign on the door
2. Perform hand hygiene on entry to and exit from the room
3. Keep door closed
4. No visitors with any type of infection/illness allowed
5. No fresh flowers or plants
6. No pets
7. No fresh, unwashed/uncut fruits or veggies
8. The patient must wear a mask if leaving the room
This device is used to immobilize the cervical spine and prevent further injury in patients with suspected neck trauma.
What is cervical collar (c-collar)?
Per the policy, "guideline for post-intervention pain score reassessment time frames", this type of intervention requires reassessment 15-30 minutes post-administration to evaluate its effectiveness in reducing pain.
What is Intravenous pharmalogical intervention?
We need to include at least 3 of these in each of our care plans for the shift.
What are SMART goals.
These 2 procedures require 2 nurses be present to help ensure sterile procedure is maintained.
What are foley catheter insertion and central line dressing changes.
This guideline advises against collecting a urine specimen from a Foley catheter that has been in place for more than _______ due to the risk of bacterial colonization in the tubing and bag.
What is 2 midnights?
Before administering blood products, it is crucial to perform this test to ensure compatibility between the donor and recipient.
What is crossmatching?
In terms of fire response, RACE stands for what?
What are Rescue, Alarm, Contain, Extinguish.
This practice is crucial for hospitalized patients as it helps prevent complications such as DVT, pressure ulcers, and pneumonia, and promotes faster recovery.
What is mobility?