Emergency Preparedness
Potential Emergencies at BIDMC
What is: infectious outbreaks (flu), loss of electricity, heat or computers, loss of computer system, mass casualty event, infant abduction, and/or hazardous material exposures.
Initial assessments
What is assessed within 24hr of admission
Care Plans
What is individualized for each patient, assessed progress daily, discontinued when resolved and documentation reflects care plans in place.
Good hand hygiene, roper PPE, and cleaning equipment between uses
What are ways to reduce/prevent infections?
8 rights to medication administration
What is the right patient, right drug, right dose, right route, right time, right documentation, right reason, right response?
Floor Marshall
The person on my unit who takes the lead during an emergency situation and works in collaboration with other departments including Public Safety and Facilities. On the inpatient units, this is typically the Resource Nurse or their designee.
Standard assessment intervals
What is once per shift, change in caregiver, and/or change in patient status
Needed when a patient is on a 1:1
What is Patient Observer hand off? signed and reviewed q shift by RN and observer. Sheet provides plan of care to keep patient safe.
Name, DOB, and MRN
What is patient double identifiers?
Can only give for reason indicated.
What is PRN medication orders?
RACE
What is fire safety. Rescue anyone in immediate danger, Alarm (pull the earnest fire alarm) & Call (2-1212), Contain the fire and Clear the corridors, Extinguish or Evacuate
Assessed prior to giving pain medication and reassessed about 15 mins after PO medications and about 45mins after IV medications.
What is Pain Assessment & Reassessment
Non-Violent Restraint Documentation
What is initial/full assessment on imitation and daily, q2hr assessment while in restraints, order good unit restrains discontinued.
Daily discussion of line need & daily CHG bathing
What are ways to reduce CLABSI?
Completed at start & end of shift, admission, transfer and d/c
What is medication reconciliation?
PASS
What is operating a fire extinguisher. Pull the pin, Aim low, Squeeze the handle, Sweep from side to side.
Standard Fall Preventions
What is for all patients, regardless of risk to fall, have:
Bed is in a low, locked position. Call light is within reach with instructions provided on use. IV pole is on same side as patient-preferred bedside exit. Pathways around the bed and bathroom are clear. Patient is wearing treaded slipper socks
Violent Restraints Documentation
What is initial/full assessment on imitation and daily, q15checks by 1:1 observer, q2hr assessment by RN, and order renewed q4hrs.
Daily discussion and nurse driven indwelling urinary catheter removal protocol
What are ways to reduce CAUTI?
Contains preservatives and expires 28days after opening or by the manufactures date, whichever comes first.
What is multi-dose vials?
Life safety square
What is a quick reference on the unit for emergency response references. Includes: emergency flip chart, evacuation information, yellow phone with phone numbers, RACE and PASS sign
Skin Assessment and Prevention Measures
What is Braden Scale and All patients have the pressure-redistribution mattress as their standard, Turning and repositioning, Limit sitting time to 1 hour, Avoid extra layers of linen, Maximize patient’s mobility and activity level
Self administered Insulin Pump procedure
What is patient identified independence in caring for pump, education provided, Joslin and nutrition c/s, patient documents on insulin pump flowsheet
Write it down, read it back, and report it to provider ASAP.
What is critical lab result reporting procedure?
Inhalers, eye drops, labeled pill splitter, rx creams