Forms
Identify Coworkers
IP
Reporting
Time Critical Care
100

Your patient suffers a cardiac arrest, code blue is called

What paperwork is required?

What is a code record.

100

The Risk Manager

Who is Sharon McCarthy

100

Aside from hand hygiene – what are 2 practices that are included in Universal Practices

What is use of PPE, sharp safety, and / or cleaning and disenfection

100

Family, nursing supervisor, Attending Physician

Who are the people notified of a death

100

You receive this notification on patient has two SIRS criteria and a documented infection

What is a SPOT alert

200

A patient falls, who receives the fall notification form?

Who is risk

200

Ethics and Compliance Officers

Who are Elizabeth Paine and Lori Merritt

200

Your patient is experiencing frequent, loose bowel movements & the provider has ordered a CDIFF test, what form should be completed and sent to the lab with the CDIFF Specimen

What is CDIFF ticket to test.

200

Tonya McCloud

Who is the person you call if you cannot remediate a patient issue 

200

Who can call a stroke alert?

What is a any colleague 

300

Patient is being sent to outside facility, what form is required?

What is a transfer form

300

Director of Plant Ops

Who is Bobby Bodiford

300

These organisms/germs are not affected by antibiotics

What are viruses

300

Charge Nurse, Director, Nursing Supervisor, AOC

What is the chain of command for unresolved issues.

300

In a septic patient, what is the timeframe to repeat the critical lactic acid?

What is within 6 hours?

400

Patient wants to leave prior to discharge, what form is required if they leave.

What is an AMA form.

400

Employee Health Nurse

Who is Suzanne Hatcher

400

True or False?  You can spray bleach onto a surface that has dried blood to disinfect it

What is: False-not all organisms and bacteria are killed with bleach

400

Reported abuse of an adult patient or minor.

Who is DCF ?

400

For critical lab results what must be completed?

What is notification to provider and documentation in the medical record?

500

What is required on every form and / or consent ?

What are the patients signature, the healthcare provider signature, date and time.

500
Pharmacy Director 

Dr. Michael Jackson

500

This spore forming organism lives for very long periods of time on surfaces

What is: C difficile

500

A patient/family complaint against the hospital.

What is AHCA (Agency for Healthcare Administration) ?

500

Who can order a STAT EKG on a patient with new onset chest pain?

Who is the bedside RN?

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