New Items
True or False: Carle will be changing IV catheters next month
True: more info coming soon including hands on practice
True or False: It's okay to leave a patient on the side of the bed without the bed alarm or in the bathroom alone as long as they are not confused and steady on their feet
False
Where is the downtime computer?
Front Nurse's station computer to the right of the printer
True or False: As a tech, I can decide what patients to apply an external catheter to
False! You may place the external catheter, but the nurse decides which patients are appropriate for one. Also, the nurse needs to sign the external out on the clipboard and send Paula or Sarah an email with the rationale
True or False: I can collect a urine culture or UA from a Foley that has been in for greater than 48 hours
False- if catheter has been in place for more than 48 hours, you need to replace it before obtaining the specimen
What is the name of the new wound cream and when do we apply it?
Zinc oxide paste- apply to irritated skin that is moist or weeping that needs to be dried before using clear barrier
How do I find out when I can de-escalate isolation?
Carle Click > Infection Prevention under departments > Isolation Resources > Isolation Removal Guidelines
Why do I need to know where the downtime computer is?
When epic/network is down, we have to do ALL paper charting. This is the computer that will print those items when we need them
Where can I go to find what doctor/PA to page on night shift?
There is a book of numbers above the sink at the Nurses' station for ortho that lists what PA works with what surgeon. Message the PA first. For gen surg and neurosurg, Perfect Serve will route you to who's on call. If you are still unsure of what to do, ask your charge nurse
True or False: I can collect a UA or urine culture from an external catheter
False: No specimens can be taken from an external catheter. If patient cannot tolerate completing a clean catch, you will need to obtain an order from the physician for a straight cath
What do I have to do to qualify to be a designated Preceptor?
What are the required shift documentation pieces for central lines?
Mid-humerus circumference, dots out, line flushing, blood return, integrity of the dress, when the dressing is to be changed, indication for line, daily CHG bath
What should I do if a patient is rating their pain a 6/10, but only requesting Tylenol, but the indication for Tylenol says to give for a mild pain rating of 1-3?
You may give the Tylenol, but make a comment that the patient is requesting it. It is important to pay attention to the PRN parameters and make sure we are documenting a reason if we are giving a pain medication outside of what the range is.
When do I complete new medication teaching for patients?
A- once a shift
B- just before they discharge
C- Once in a 24 hour period
D- Just when they are admitted
A- once a shift. Also, don't forget to complete the education when a patient discharges and attach teaching related to admitting diagnosis
When does a patient need a COVID test that is going to be in a shared room?
Patients still need a COVID test before going in to a shared room. No longer needing testing on Tuesday, Thursday and Saturdays. If a patient develops new symptoms, may need to re-evaluate this and discuss with physician
What new assessment pieces will be added to the wound vac LDA?
1. Dressing changed
2. Dressing change meds
3. Drainage characteristic/odor
4. Removal reason
5. Option to select purple or gray sponges
6. Option to select "therapy on hold" and "WDL" when appropriate
True or False: If I suspect a patient has measles, I should not wait for the test results to come back before putting the patient in isolation
True. If you suspect a patient has measles ( fever, rash, Koplik's spots, cough, runny nose/eyes) put the patient in airborne isolation ASAP
Of the following items, which can be left on the COWS?
Needles, syringes, a sticky note with my name on it, med cups, snacks incase I miss breakfast, scissors, coffee incase I get crabby
Med cups
True or False: I can put in an order for a new medication as part of the nursing driven protocol
False- the only items that can be put in under "Standard" or "Hospital Protocol" are orders that can be advanced per an order set, an order for social work or pastoral care consult, or per hospital protocol such as the basic care protocols
For techs: Which of the following vital signs should be reported to the nurse?
a. BP of 179/99
b. pulse ox of 88%
c. heart rate of 95
d. temp of 98.9
a, b
True or False: I have 24 hours from the time the patient is admitted to the unit from the ER to place the appropriate arm bands on the patient
False: immediately upon arrival to the unit, the appropriate arm bands should be in place. If you get a patient from the ER and the ER nurse has not placed the bands, please give us this feedback
Which of the following patients need a MRSA swab prior to admission? Select all that apply:
a. Patients being admitted to ICU
b. Patients with a chronic wound
c. Patients who are missing teeth
d. Patients with an active history of MRSA within the past 24 months
a, b, d