Infection Control
This is the reason for a clear area around sinks
What is- supplies can be contaminated by dirty handwashing splashes
This should be done before any invasive procedure to prevent wrong patient / wrong procedure / wrong site events.
What is Time Out.
Medication Reconciliation should be performed in the following situations
What is:
1. when transferred to a different level of care
2. on admission
3. on discharge
This is the reason that equipment should not remain stored in hallways.
What is the need for safe exit route in a fire or other emergency. It can be impossible to see a safe exit route when the unit is filled with smoke. Running into equipment while evacuating can cause both staff and patient injury and death.
This must me performed and documented for any patient entering the MRI
What is the MRI checklist
this is the reason that equipment, floors, and other items should not have tape or adhesive residue
What is adhesive can trap microorganisms and be difficult to disinfect
This form should be checked to confirm whether patient requires oxygen
What is "Smooth Sailing"
These are not medications, but are required to be secured in a similar manner to prevent access by non-authorized persons
What are needles and syringes
Placing an oxygen tank here when transporting a patient in a bed or stretcher can start a fire.
What is on the mattress with patient. 100% O2 can saturate bed sheets and clothing. Oxygen tanks should only be transported in designated carriers or compartments on beds and stretchers, and never placed on mattresses.
This must be done for each patient before performing a procedure
What is confirm identity using 2 patient identifiers
this is the definition of "wet time"
What is the length of time that disinfectant must stay wet on surface in order to kill microorganisms
This is how you know the code cart has been checked and is ready for use
What is the Code Cart checklist?
These are 2 examples of an unapproved / do not use abbreviation, that must be clarified with provider if found in a medication order
What is: qd, q.d., qod, q.o.d. Q.D., QD, QOD, Q.O.D, MgSO4, MSO4, MS, U, I.U., 1.0 (trailing zero), .1 (missing zero.)
This is the reason that items should not be placed on the floor in front of medical gas shutoff valves or electrical panels.
What is the need for fast, unobstructed access in an emergency.
This is the reason we require certified medical interpreters when communicating to patients who require translation.
Family, friends, or caregivers may be fluent in the patient's native language, but not fluent in medical terminology. The only way to ensure that translation has happened accurately is by using interpreters that have been deemed competent to translate medical information.
This is what to do if the surface does not remain wet for manufacturer's specified wet time (contact time.)
What is spray or wipe with additional disinfectant
These two things must be done for any patient who indicates that English is not their preferred language to receive health care information. They help to ensure patient understanding of their treatment, and facilitate informed decisions about healthcare.
What are
1. offer translated consent forms and
2. offer a certified medical interpreter for healthcare conversations. (This can be provided by phone. Patients have the right to refuse a certified medical interpreter. Refusal should be documented in the medical record, along with the name and relationship of any caregiver they choose to use instead for interpreting.)
These must be contained within orders whenever more than one medication is prescribed for the same indication, in order to prevent therapeutic duplication
What are parameters? for example:
Tylenol for mild pain 1-3, Percocet 5mg for moderate pain 4-6, Percocet 10mg for severe pain 7-10. If there are no parameters or conflicting parameters then the order must be clarified in order to keep within the scope of RN license.
Name 3 non-clinical emergency codes, what they stand for, and how do you know what is expected of you in response?
For any facilities emergency code, consult the EOP manual on AnnaOnline for expected staff response.
1. Code Red - fire
2. Code Amber - infant or child abduction
3. Code Orange - bomb threat
4. Code Silver - active weapon
5. Code Evac - full or partial evacuation
6. Disaster Plan - Influx or movement of patients due to internal or external emergency
7. Lockdown Plan - all entrances locked except for ED walk in
The name of the process performed before invasive procedures that includes time out, site marking, and procedure confirmation to prevent wrong patient/wrong site/wrong procedure events
What is Universal Protocol
These situations require high level disinfection of the ultrasound probe
What is
1. contact with mucous membranes?
2. contact with wound or non-intact skin
These should be done before sending an inpatient patient back to the floor
1. Check Smooth Sailing form for oxygen requirements
Describe the steps for cosigning/verifying a high alert medication. What is the most important element of this process?
*Most important element = independent verification*
Do not have the other nurse walk you through it - our brains can often trick us into seeing what we expect or want to see. You are signing off that you confirmed everything independently and came up with the same answer!
Steps:
2 nurses each verify independently from each other:
1. confirm patient and order
2. view applicable lab values
3. view scale/perform drug calculation
4. confirm that each came up with same answer
5. confirm correct medication vial/bag
6. confirm correct dose in syringe/ pump rate
In the event of an evacuation, what is your department's designated safety area?
Consult Emergency Operations Plan Annex 28 - Safe Zones
These 2 things must be done for any inpatient on oxygen before they are sent back to the inpatient unit
Check oxygen tank to ensure flow is correct and tank has an adequate supply of oxygen