Vital Signs/Pain Assessments
Vital signs should be done how often on ED patients?
Minimally every 4 hours, or more often based on clinical status
When does an order need to be placed for non-violent and violent/chemical restraints
Non-violent- prior to application of restraints
Violent- within 1 hour of application of restraints
At the bedside
Can a preceptor and orientee complete a dual sign off together?
No
True/False: Preceptor forms do not need to be discussed or signed by the orientee
False
Pain reassessments should be done within what time frame after pain medication is given.
Within 1 hour
A confused elderly patient keeps trying to climb out of bed - this should be tried first.
Reorientation, sitter use
What is the most important step before any lab draw?
Checking 2 patient identifiers
How do you check 2 patient identifiers on a patient who is aaox4?
Have patient sell their full name and birthday
Bonus: What is the correct process for discharging a patient
How many weeks does a FT/PT hire have on orientation?
Vital signs must be completed within what time frame prior to discharge
Within 1 hour
What is the order length for nonviolent and violent or chemical restraints?
Nonviolent - 24 hours
Violent/chemical - 4 hours for adult, 2 hours for child 9-17, 1 hour for child <9
What is the fill level for adult blood cultures?
8-10mL
What blood sugar value should one initiate hypoglycemia protocol?
70
When should the competency packet be completed and who signs it
At the end of the shift, signed by preceptor and orientee
True/False: If a patient doesn't have pain, no reassessment needs to be done.
False
Bonus: How often should pain reassessments be done?
These medications are used to control behavior or agitation and are considered a form of restraint
Chemical restraints
Where should blood cultures be drawn from
2 separate sites for adult patients
How often should glucose checks be repeated during hypoglycemia protocol?
Every 15 minutes until over 100
What feedback should be discussed with the education team in real time?
Red flags
Your patient is on a vasopressor, how often should vital signs be completed?
As per MAR instructions for titration
What is the documentation for chemical restraints
Every 30 minutes - patient response
Every 2 hours - circulation, respirations, elimination, skin and position, and limb release
Every 4 hours - VS, fluid/nutrition and ambulation
What complication can occur from prolonged tourniquet time?
Hemoconcentration of specimens
Specific, Measurable, Achievable, Relevant and Time-Bound
What is a SMART goal
True/False: "Better time management" is appropriate feedback to put on a preceptor form
False
Bonus: What is a SMART goal related to time management?