Policy/Procedures
BLUE BABY! PANIC! (JK, don't panic).
What are your next steps?
When are you reassessing your pain intervention?
Document within 60 minutes.
(Discuss post-Motrin administration for L&D RN)
Uh-oh! Your patient's bed just fell apart! What do you do?
1) Remove from service
2) Tag it
3) Call appropriate department
4) Send leader an email
How many minutes should a transfer from SE3 to SE2 take for a vaginal delivery? C/S?
Vaginal: 10
C/S: 15
Be ready! Report pertinent information only.
Can a SE2 RN give "eyes and thighs" on SE3?
Absolutely!
Hypoglycemia algorithm: list 5 risk factors.
Great job listing the risk factors! ;)
Don't forget any amount of PPV needs blood sugar monitoring.
Your NNP is busy performing the initial steps of NRP when you have an OB STAT to the Main OR for a baby of unknown gestation.
What member of the Birth Center team should lead NRP while awaiting the NNPs arrival?
NICU RN (or resource RN).
The MDA places an epidural, the patient is having a PPTL the next morning, they request you leave the catheter in, what do you do?
1) Remind MDA of our current practice
2) Remove catheter and document
L&D: you are already continuously monitoring a patient off unit on W3.
The ED calls and requests a NST on a 25 weeker.
What do you do?
Grab another monitor! We have more than one :)
Your patient has been verbally aggressive & refusing cares. List 3 things that you can do as the RN.
1) Listen to your patient; what are their underlying concerns? Do they understand their options?
2) When appropriate, remind them of our patient code of conduct.
3) Fill out MIAHTAPS, add "swirly" to door.
4) Pull in social work for support. Consider a behavioral contract.
5) Security department for awareness or presence. Can request more frequent rounding.
6) Leave the room, if needed!
BP: 161/89. What are your next steps?
1) Notify MD
2) Check sizing of BP cuff
3) Recheck in 15 minutes.
4) Check for PRNs
Your scheduled C/S needs a shave, where (location) should the hair cut take place?
Outside of the O.R.
Glucometer result reads 40 for a newborn. What is your next step?
TREAT!!!! Do not repeat to try and get a higher number.
The ED announces overhead, “OB STAT Emergency Department”. What is the role of the charge RN? L&D RN? NICU RN? Postpartum RN?
L&D Chg: Deploy L&D RNs to ED (2). Call ED charge to get information.
PP Chg: Deploy NICU RNs (1-2), cover NICU unit.
L&D RN: Bring "grab & go" pack and transport isolette.
NICU RN: Ensure NNP en route, bring NICU crash cart.
Postpartum RN: Anticipate admission, get room ready. Help cover NICU, if needed.
List 3 reasons to perform bedside safety hand off.
1) Patient safety: review drains/drips (especially high-risk medications)
2) Patient experience: including them and introducing yourself.
3) Ability to "triage" patients' needs
4) Reduced call lights during shift change
Your baby slips out headfirst onto the floor, what should you do?
Immediately assess your newborn, call a NICU assist, follow our newborn fall protocol (direct admission to the NICU), place aware event.
Your patient is going to be transferred to Mental Health. Which navigator will you use?
"Transfer-Arrival Nav" that will read Medicine to MH Transfer checklist.
You can wrench this in!
Iphone: how do you get in touch with OB Junior?
Call via Vocera genie -OR- secure message the "Birth Center Junior Resident"
It is Taco Tuesday, and the Main OR does not have an available spot for a PPTL. The OB team adds her to the “add-on” case list. Your 1100 C/S refuses to come in. What can you do?
Perform the PPTL in L&D!
Payroll close: don't touch timecard after...
Sunday of payroll week after 9am.
Which types of withdrawing newborns would we score ESC on?
All newborns that are withdrawing!
We would only treat opioid exposure with Morphine.
Your patient is scheduled for a PPTL at 1600 and your order says NPO at midnight. As their RN, what would you do next?
1) Tell MD to change their NPO status to 8am (8 hours prior to scheduled time).
2) Pre-op prep: Hibilcens, pre-op checklist, consent signed, etc.
What is the significance of the red power outlets?
Generator driven during outages.
You are finishing a C/S in OR1, a STAT is called to OR2. What department should have awareness that we no longer have an available OR?
The L&D Chg RN will call the main OR Chg RN for situational awareness.
Who should make a CPS report?
The individual who witnessed the concern/event. However, ALL can submit a CPS report.