The LVAD Patient
Policy and Procedure
Infection Prevention
Safety
Potpourri
100
Must have education topics for patient with LVAD and family of the LVAD patient:
What is: What to do in an emergency Signs and symptoms of infection Signs and symptoms of stroke How to contact VAD (MCS) team Medication Management Daily Device Management
100
Available 24/7 @ 23400.
What is The Mechanical Circulatory Support (MCS) team? Before 5p on weekdays or anytime for device issues; After 5p Cardiac/Thoracic Surgery (CTS) Fellow 82251; CMET 122 also available 24/7
100
This is the most effective intervention to stop the spread of infection.
What is hand hygiene (hand washing, foaming in/out)
100
In the event of a fire, RACE stands for
What is R-rescue the patient A-activate the alarm C-contain the fire E-extinguish or evacuate
100
The standard tool used for hand off communication.
What is S-Situation B-Background A-Assessment R-Recommendations
200
Something the patient receives prior to their device implant; location of this document; importance of this document.
What is the letter of acceptance to LVAD program defining placement outcome for example BTT or DT. Also discusses the multidisciplinary team commitment to services related to device implant. Located in chart review>letters tab>written by a member of the VAD (MCS) team.
200
The 5 Rights of Medication Admistration.
What is Right Patient Right Medication Right Dose Right Time Right Route
200
The current Cleveland Clinic Mechanical Circulatory Support (MCS) Left Ventricular Assist Device (LVAD) Program Performance Measures.
What are Drive Line infection at 24 months; Neurological event at 24 months; Mortality at 24 months; 30 day unplanned readmission?
200
Activate the emergency response teams
What is 111-code blue or pink 122-medical emergency 123-crisis intervention
200
Pathway that demonstrates your patient Advanced Directive information.
What is, EHR>EPIC tool bar right side where "AD" click link to view.
300
This is an initial confirmation and agreement between Team and Patient prior to device implantation whereas the patient agrees to the surgical procedure, understanding risk and benefits to program and device, and commits to program. Describe unique location.
What is VAD (MCS) informed consent. Often found in archival, green chart, and remains on paper.
300
This is reflective of the patient problem list, for the most part is ongoing, and documented by the nurse.
What is Nursing Plan of Care?
300
Standard or Universal Precautions include:
What are gloves, gowns, mask, goggles, shoe covers. Treating all blood and body fluids as infectious so employee is always protected.
300
National Patient Safety driven initiative; Fall prevention interventions
What is yellow socks yellow wristband yellow fall symbol My Safety Plan hourly rounding
300
Name a Process Improvement project your unit is working on.
What is hand hygiene, CAUTI/CLABSI bundle, skin care initiatives, etc.
400
Page 2-clot and primary team; CRITICAL test; time from order to result; obtain and document appropriate nursing interventions
What is BRAIN ATTACK CT scan-CRITICAL test 45 minutes from order to result Vital Signs including temp and sp02, blood glucose, neuro exam; last know well; neuro checks; NPO
400
THIS should be limited to urgent or emergent situations where it is impossible or impractical for the prescriber to enter it into the electronic medical record (EMR). Although An LIP with computer access is always available the appropriate answer for accepting personnel of THIS is that they “would verify the order by a read back process”.
What is a Verbal Order
400
When Hand Hygiene should be performed.
What is 1. Before patient contact 2. After contact with patient or their environment 3. Before performing an aseptic technique 4. After contact with body fluids, blood or visibly contaminated surfaces 5. Before and after using gloves
400
Safety instructions for chemicals that are used daily on the unit and they are found......
What are Safety Data Sheets Found on Intranet home page
400
Check privileging of staff physician, Advance Practice Nurse, Physician Assistant
What is Intranet home page, All Log In Accounts, E-priv
500
This is an unexpected occurrence involving death or serious physical or psychological injury or the risk thereof.
What is a SENTINEL EVENT immediately reviewed at the local level and managed up reviewed at an organizational level as well reported internally through the Safety Event Reporting system located on the Intranet>Quality, Safety & Patient Experience>Safety Event Reporting System (SERS)
500
This process can only take place with a physician order the patient is instructed and responsible for ITS security. The key is to be kept on their person, not in the box. Nursing has oversight to insure that ITS carried out properly providing education and support.
What is Patient Medication Self-Administration Process
500
The 2013 International Society of Heart and lung Transplantation Guidelines for mechanical Circulatory Support: Executive Summary
What are Clinical Practice Guidelines? Used as the supporting evidence for the LVAD Program
500
The steps that the employee must take with a blood borne pathogen exposure (needle stick or splash)
What is first aid-immediately clean area report to Exposure Hotline, manager/supervisor complete a SERS
500
Resident and fellow job descriptions
What is Intranet home page-Education-resident and fellow job description or Clinical Resources-resident and fellow job descriptions
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