Clinical Knowledge
The definition of a stage III decubitis ulcer.
What is a wound caused by pressure that is open with exposed fatty (subcutaneous fat) tissue but the muscle, tendon and bone are not visible.
The standard work for patients with central lines.
What are daily CHG baths and weekly central line dressing changes?
The GEMBA quality care initiative for our patients.
What is trending our HCAHPS results?
Focusing on pain management, communication about meds, and creating a quiet environment for our patients. .
The person who watches your patients when you go to lunch/answers your questions when you don't know something.
Who is your Work buddy? :)
The types of patients that cannot have blood pressures done on one or both arms.
List two.
Patients with a(n) history of unilateral or bilateral mastectomies, AV fistula, PICC line, arm wound, lack of extremity, insufficient circulation, or broken bone.
The correct procedure to follow when dealing with a Code 99.
Give the first 3 steps:
What is:
1) Identify patient who is coding. Tell coworker to call 55 to "call in" the Code 99 for pt room #____.
2) Pull the emergency light to help identify what room you are in.
3) Start BLS/CPR
The GEMBA financial initiative for 4EW.
What is the Discharge Rounding process with social workers?
The Discharge Rounding process is done on dayshift daily during the week with Social workers and Team Leaders who confer with all nurses about patients who have a length of stay 2-3 days or greater or who have social work needs. The goal is to reduce length of stay to an average of 0.9 days.
The blood pressure value considered emergent that needs immediate reporting to the patient's RN.
A type of continuous IV drip/medicine that cannot be shut off.
What is a Heparin drip or D5NS drip for a brittle diabetic?
The patient specific drawers in the RxStation, the IV fluid bins next to the refrigerators, the refrigerator, or (on the 4E side) the patient bins in the cabinets.
NOT THE COUNTER :)
1) All d/C meds [statin, antithrombotic, etc..]
2) Risk factors for stroke [e.g. HTN, HLD, obesity]
3) Warning signs and symptoms of stroke [F-A-S-T]
4) Activating EMS for S/S of stroke
5) Follow up after discharge [support groups, follow-up appointments]
6) Charting on VTE prophylaxis [e.g. SCD/Teds, or charting refusal]
The time we are supposed to show up at GEMBA.
What is 11:10am?
The (living/residential) requirement for patients to qualify for Home Health.
What is: the patient must be homebound.
4E: What is the HUC station?
4W: What is the back 4W med room?
The appropriate steps to follow for Baker acts with insulin pumps.
What are the immediate removal of the insulin pump as well as notifying the doctor for alternative insulin therapy?
What is the GEMBA operational initiative?
What is RN-MD patient rounding and RN-PCA shift report?
List three reasons to CCAT a patient.
What are:
1) Change in mental status (sudden confusion, unresponsive, seizure)
2) Change in respiratory status (e.g. increased difficulty breathing, 26 < RR < 12
3) Change Hemodynamic status (E.g. 110 < HR < 50, 180 < Systolic BP < 90, Urine Output < 100mL in 4 hours).
The AHCA/Joint Commission Survey readiness Checklist items.
(Hint: Gives specific instructions for what to do with Accu-checks, flushes, etc).
List at least 3.
What is:
1) 8ft hallway clearance
2) No flushes/syringes in patient rooms or RN stations
3) Accu-check strips and QC's labeled with open/expire dates
4) Code Carts clean and stocked
5) Drinks @ Drink parks only
6) Blanket warmer not > 130 degrees F
The GEMBA safety initiative.
What is the CLABSI and CAUTI protocols?
CLABSI = daily CHG baths and weekly dressing changes
CAUTI = prioritizing foley removal every 8 hours! - twice on dayshift, once on nights) or foley care
The Accu-Check value considered "critical" that needs immediate reporting to the patient's RN.
What is a blood sugar less than 70 and greater than 400?