Documentation
Patient History is required documentation when?
What is on admission
When each piece of equipment should be cleaned?
Between each patient, and you need to wait for it to dry.
Is adhesive tape ok to secure anything to patient equipment items?
No, Adhesive tape is not ok on any patient equipment. Infection prevention issue.
Right patient, dose, route, time, Right medication.
When patient identified as High fall risk, Needs to have in place?
What is Bed/ chair alarm, yellow sock, and yellow arm band.
Alert signage, call bell in reach.
Requirements on every patient form?
What is signature, date and time.
And witness, depending on the form.
True or false, lancets have an expiration date?
Length of time that glucose strips expire when?
QC liquid expires When?
QC liquid are 90 days, and need to be dated when opened.
5 moments of hand hygiene are?
Before touching patient
Before aseptic Procedure
After touching patient
After touching patient surroundings.
After body fluid exposure
Pxyis count requirements?
What is accessed every shift and complete narc count every monday.
Who gets and what are universal fall precautions?
What is, every patient:
Clear pathways, clear floors, (no cords), 2 side rails up, call bell in reach, nonskid socks, patient education, bed in lowest position, frequent purposeful rounds.
A patient cannot sign out AMA when?
When they are a baker act (legal hold), and if they are not alert x4.
Would need Proxy to sign them out.
Hygiene care should be completed and documented?
What is each shift documented, and completed bed bath, linen change minimum every day.
Grey wipe dry time
What is 3 minutes?
The cactus is used for ?
What is wasted medications, liquid, pills, and patches.
Reason, its against Osha standards to wash them down the sink.
A purposeful round includes
4 P's
Pain, potty, position, proximity,
An intentional round on patients every hour.
Yellow DNR form is good for how long?
What is 24 hours
Intake and Outputs are required documentation how often
What is every shift. and this include zero if intake or output is zero?
Orange wipe dry time
Egres means?
Fire and evacuation safety. Clean pathways, fire doors, ect.
When is ok to withhold a medication?
With a physician order, when outside of parameters.
Same question when to document refusal, when patient refusing.
The PCT role in a rapid response
What is grabbing glucose monitors, vitals carts, performing chest compressions if needed, and crash cart if not yet grabbed.
Needed for releasing patient information?
What is patient privacy code, or patient verbal consent, or signed medical release through medical records?
Language line is required to be documented when
Every shift x 2. Assessment and education.
Every consent, and when performing admission history, discharge, discussing plan of care, and administration of medication.
Whose responsibility is it to keep the TNCU breakroom clean?
Linen cart should be left how?
What do you do if its an unfamiliar medication, or first time giving a new medication?
Fall prevention agreement meant for and done when?
What conversation between primary nurse and patient to agree upon fall interventions, including education, rationale, and is done on every admission.
Under intranet, under LRMC Applications, click Privileges, search provider, Name, NPI or specialty.
Telemetry Escalation process for Leads off?
Telemetry escalation process for low battery or one lead off??
2, 2, 1
5, 5, 5
Telemetry documentation is required how long after order is placed?
30 minutes
Urinals, bed pans should be maintained in the patient's room how?
What is cleaned and emptied after each use, and labeled with room number and initials of patient?
Suction canisters, emptied using solidifier.
Black bin is used for disposing of?
What is Heparin, Black box medications, Should be no iv tubing, no gloves, no trash, and no narcotics.
what is SBAR format
1. Identify patients correctly (2 patient identifiers)
2. Improve team communication
3. Use medication safely- before procedures, label medications, extra caution with blood thinners, Record and pass along correct information such as home medication. Give patient written information about medications they need to take, such as on discharge.
4. Use alarms safely
5. Prevent infection
6. Identify patient safety risks- such as suicide
7. Prevent mistakes in surgery
8. Improve healthcare equality- Such as with low income or low social economic populations.
Where in expanse is medication titration documented?
Under specialty documentation, under worklist.
Airborne Precautions PPE requirements
What is, gown gloves, N-95 or equivalent. Faceshield for enhanced airborne.
Temp of the blanket warmer?
CHG warmer temp?
Freezer temp?
Refrigerator temps?
110 Degree F
104 Deg F
0 to -10 Deg
41-33 Deg F
Steps to take to collect a lab specimen?
Review order, explain to patient, grab supplies needed for type of order( ie clean catch ect.), Bring immobile and mobilab printer to the bedside.
Verify two patient identifiers.
Print label at bedside.
Label specimen
Send specimen in specimen bag correctly labeled to lab.
Temperature logs help us ensure, and are where in the unit, and checked how often?
Ensure proper temperature so we can administer safe care without causing patient harm, located in fridge, clean supply room, blanket warmer, and chg warmer.
And checked daily.
The High level disinfection Process includes?? (When performing a bedside procedure with sharps that need to go down to decontamination)
Once completed with procedure in the room.
1. Bring box located in the supply room to the patient room.
2. Using PPE, place sharps in bin and bring to soiled utility room.
3. Spray items with ENZYMATIC SPRAY to evenly cover. Wrap with biohazard strip label.
4. Then immediately transport to Decontamination area in the Sterile Processing Department