Blood Infusions/Consent
Blood products must be infused within ____ hours from the product issue time. Until ready to administer, blood units should remain at _____ temperature.
4 hours, room temperature
What does HIPPA stand for?
The Health Insurance Portability and Accountability Act.
May patients on high risk for suicide or elopement precautions go off the unit if a staff member accompanies them?
No. These patients may not leave their unit for nonclinical activities under any circumstances.
How do we communicate that a patient has a legal guardian? (2 criteria)
1) A "No Consent, Patient has a Legal Guardian" sign must be placed above the head of the patient's bed.
2) A banner within EPIC indicating the patient has a guardian
Who is our CNO (Chief Nursing Officer)?
Paula Fessler
What 3 criteria are necessary on the consent form to be filled out by the physician and how long is informed consent valid?
1) Physician's signature
2) Date
3) Time
Signed consent forms can be obtained up to 60 days prior to the scheduled treatment or procedure and the same form can be used but just re-dated and initialed by both patient and a member of the health care team if the consent was signed greater than 60 days.
How does BJH inform a patient about HIPAA privacy rules? (3 criteria)
1)At registration, all patients are asked if they would like a copy of the Notice of Privacy Practices.
2)The Notice of Privacy Practices sign is posted near registration desk areas.
The Barnes-Jewish Hospital (www.BarnesJewish.org) and BJC (www.BJC.org) public-facing websites include the Joint Notice of Privacy Practices in large print, as an audio file, in American Sign Language, and in 15 languages.
What immediate steps should be taken when an abuse allegation is made by a patient? (4 criteria)
1) Remove alleged abuser from patient care
2) Contact Unit Manager/House Supervisor and Risk Management
3)Request a provider to examine the patient
4) Round on all patients, asking general questions about their care experiences to help determine if other patients have had potentially similar concerns with the same individual.
Can a physician's order or medical judgement override a judge's order?
No, the judge's order is legally binding over a physician's judgement.
What are our BJC Values?
Compassion
Respect
Excellence
Safety
Teamwork
What checks are required prior to requesting products from the Blood Bank? (5 criteria)
1)Informed Consent form completed
2)Type and screen is current (72 hrs)
3)Orders placed to "Prepare (type and cross for Blood bank) and "Transfuse" (order for RN to infuse product
4)Assess transfusion hx/reactions/need to diuretics
5) Patient has an IV of appropriate gauge is patent
What are the 6 Patient Medication Administration Rights?
Right
1)Patient
2)Drug/Medication
3)Dose
4)Route
5)Time
6)Documentation
How often are restraint orders needed to be renewed? (violent vs non-violent vs ICU)
1) Every 4 hours for violent/self-destructive behavior (Order name: Restraints Violent)
2) Each calendar day in non-ICU settings for use of non-violent restraints (Order name: Restraints Non-Violent)
3) Each episode of use for ICU use of non-violent restraints (Order name: Restraints Non-Violent ICU Only)
What is an Advance Directive?
What is our BJC Vision?
BJH along with our partner WashU, will be national leaders in medicine and the patient experience.
For inpatient admissions, the H&P must be completed no more than _____ days before or within _____ hours of admission. To be considered "complete" it must be signed by the attending physician.
30 days, 24 hours
At the time a sterile preserved multi-dose vial is opened, the BUD (beyond use date) is recorded on the label by the RN. The BUD is the _____th day following opening.
28th day
All preserved vials are to be discarded after 28 days of opening or on the manufacturer's expiration date, whichever is sooner; or when the med is discontinued or the patient discharges.
What does the order for a restraint need to include? (3 criteria)
1) Medical reason for restraint
2) Patient behaviors requiring need for restraint
3) Type(s) and/or location(s) of the restraint to be applied
The type/location on the order must match the type/location of devices currently on the patient as well as the documentation in the flowsheet.
What is a Durable Power of Attorney?
A document that names another person to make decisions for the patient when he/she is no longer able to communicate their wishes.
What is our BJC Mission?
We take exceptional care of people.
What are the vital sign requirements when monitoring transfusions (4 criteria) and how often should they be obtained? (4 criteria)
Assess and document :
T, P, R, BP at these intervals and with any symptom development:
• Pre-transfusion, within 15 minutes of initiation.
• 10-15 minutes after transfusion start time (product reaches the patient); taken by licensed staff only.
• At least hourly during the transfusion (no longer than 60 minutes from the last set of VS taken).
• Post-transfusion, within 30 minutes of completion.
Ultrasound gel, once opened, should be dated with the open date and the ____day expiry date.
Single dose/Single use sterile vials must be used within _____hour(s) of the original entry.
Multi-dose non-sterile products expire when?
Sodium Chloride bottles for irrigation and sterile water expire ____ hour(s) after opening.
Ultrasound gel-30 days
Single dose/Single use sterile vials-1 hour
Multi-dose non-sterile products-The manufacturer's expiration date noted on the product
Irrigation bottles of NS or sterile water-24 hours
Explain how we determine No risk, Low risk and High risk for self-injurious patients?
No risk- Patient with no hx of self-injurious behavior
Low risk- Patient with a positive hx (w/in past 30 days) but is not actively demonstrating behaviors while hospitalized
High risk- Patient with a positive hx and is actively demonstrating behavior while hospitalized that is self-injurious or unsafe to themselves (Needs 1:1 observer)
What does it mean for a patient to have a legal guardian?
These patients have been deemed legally incapacitated by a judge. The incapacitated person is known as "The Ward." The judge appoints a legal guardian as the legal decision maker. All decision making is transferred from the ward to the guardian.
How to we carry out/what do we do to ensure our BJC Mission? (4 criteria)
1) Providing world-class health care
2) Delivering care in a compassionate, respectful, and responsive way
3) Advancing medical knowledge and continuously improving out practices
4) Educating current and future generations of health care professionals