TJC Need to Knows
What are best practices related to medications in patient rooms?
-Saline flushes and meds not in room/computer
-inhalers/creams placed in pt lock box (non-formulary pt meds-Omnicell only)
-make sure no meds in lock box from prior pt
-pill cutters labelled with pt name (not multi-use)
Who is the person on the unit that takes the lead during an emergency situation?
The Floor Marshall (aka resource nurse)
An initial assessment of your pt needs to be completed with ______ hrs of admission.
24 hours
#1 practice to best prevent the spread of infection to our pts and ourselves
Hand Hygiene
How often do you need to check/document on a pt that is ordered for Violent Restraints?
Every 15 minutes
What are the 8 med rights?
-right patient
-right medication
-right route
-right dose
-right reason
-right time
-right documentation
-right response
What is the Life Safety Square?
In an emergency, refer to this area with quick reference flipchart, evacuation information, and the yellow phone with specific phone numbers.
When do you reassess pain after med administration (IV vs PO)?
IV- about 15mn
PO- about 1hr
What are some examples of CLABSI prevention practices?
-"scrub the hub" for 15 seconds
-alcohol infused caps for IVs
-change all IV drsgs when old blood at site
-complete central line drsg changes weekly and cap changes
How frequently should you assess a pt in Non-Violent Restraints?
Every 2 hours
When opening a new bottle of insulin, how many days until expires? And how do you know this?
1) 28 days
2) There is a sticker with set date by pharmacy on bottle
* If no sticker, please notify pharmacy to label
What is the acronym RACE stand for?
Rescue/Alarm/Contain/Extinguish
What steps do you take in the event of a blood transfusion reaction?
1) stop transfusion, don't discard blood-keep tag attached at all times
2) obtain VS, flush line with NS slowly
3) notify MD, complete blood transfusion reaction form (PPGD) and RL-6.
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What are some examples of CAUTI prevention practices?
-reassess pts w/ foleys following the NDP
-avoid IUCs, use external devices/interm str cath
-peri care daily and prn, bath wipes not basin
What is the responsibility of the patient observer? And how do they know how to care for this pt?
1) To stay with the patient at all times, in full view
2) Get a handoff from the nurse that tells them what the patient's needs are, their behavior, fall risk etc.
Also- hands/head/neck need to be in view above blankets at all times
How many days after opening ultrasound gel and/or telemetry electrodes (aka stickers) until the expire?
28 Days
* do not dump electrodes out in basket- they should remain in packaging
What does the acronym PASS stand for?
Pull/Aim/Squeeze/Sweep
When would you use a the PAINAD scale vs Wong-Baker scale for pain assessment?
PAINAD- pts with dementia
Wong-Baker- >4yrs age, facial descriptions
Purple top wet time
Purple (General env't)= 2 minutes
What are suicide precaution interventions?
Removing all potentially harmful objects from patient room
Ordering a "safety tray" for meals
Obtaining an order for a patient observer.
For non-English speaking pts, how do you obtain an interpreter and what documentation is required?
1) Put in Interpreter Services consult order in EPIC
2) Utilize interpreter iPads-need to document if pt refuses
3) Take interpreters ID# and document in note
In the event of an emergency/disaster, how would you be notified?
Through AlertMedia which is BIDMCs emergency notification system
Name 3 Fall Prevention interventions
1) bed locked, low position
2) call light within reach, path clear
3) treaded slipper socks
How do know whether a piece of equipment is clean?
Assume it is dirty- wipe down 1st!
What is the training/education I receive to safely care for pts in restraints?
Completion of a restraints application skills list upon hire
Annual MyPath
Reference to PPGD CP-28 Restraints and/or Seclusion