Care Pathways, Care Plans, Education, EDD
During interdisciplinary rounds, this projected date helps guide discharge planning and resource coordination
This should occur before the end of shift to ensure continuity of care.
What is Transfer of accountability (TOA)?
This rounding framework focuses on Pain, Positioning, Personal Needs and Personal Environment.
What is 4P rounding or Purposeful rounding?
This is the frequency in which vital signs must be taken for a patient in the first 48 hours of admission to your unit.
What is Q4h?
This protocol must be initiated when a patient’s blood glucose is below 4.0 mmol/L.
What is the Hypoglycemia protocol?
When a patient’s condition changes, this must occur to maintain safe and appropriate care
What is updating the care plan?
If a nurse disagrees with a plan of care due to safety concerns, this professional action is required.
What is respectful escalation and advocacy?
This item must be within patient reach to promote independence and safety.
What is the call bell?
This assessment tool is used to evaluate sedation in patients receiving opioids.
What is the Pasero Opioid-Induced Sedation Scale (POSS)?
This area of the patient chart in Epic lists required documentation on admission.
What is the admission navigator?
If a patient’s condition changes and discharge is delayed, this documentation/communication action is required for EDD rounds.
What are barriers to discharge?
This standardized communication framework is required during Transfer of Accountability at Lakeridge Health to ensure critical information such as situation, background, assessment, and recommendations are clearly communicated.
What is SBAR?
At Lakeridge Health our patient care standard for purposeful rounding is
What is minimal 2 hour rounding.
This early warning scoring tool helps identify patient deterioration using vital sign trends.
What is NEWS2 or Early Warning Score?
These are entered by physicians pre-emptively in advance to a patient arriving to a specific unit or before a procedure.
What are signed and held orders?
When using the teach-back method, this specific element must be charted to show effectiveness of education.
What is verbal understanding or demonstrated understanding?
During TOA these things are communicated without exception. Including: patient name/MRN, Code Status, Allergies, Admitting Diagnosis, PMH, Significant Assessment, Orders, Labs, Tests.
What are critical pieces of information?
During administration, high-alert medications such as insulin, heparin, or PCA infusions require this safety-focused verification process between two nurses.
What is an independent double check?
This vital sign must always be assessed alongside POSS when opioids are administered.
What is respiratory rate?
When administering an IV medication that you are unfamiliar with, this resource should be reviewed to confirm dilution, rate, and monitoring requirements
What is the IV medication Monograph?
During the acute phase of any care pathway (COPD, Stroke, CHF), failure to document reassessment after intervention compromises this key professional obligation.
What is demonstrating safe, accountable, and evidence-informed nursing care?
This standardized framework is used at Lakeridge Health to guide safe transfer of accountability during handover.
What is IPASS BATON?
This technology reduces medication errors by verifying the right patient and right medication.
What is BCMA (Barcode Medication Administration)?
This finding may indicate fluid overload in addition to positive fluid balance.
What are edema, crackles, or increased shortness of breath?
This documentation assessment is important for providing information to allied health care team members during EDD rounds.
What is Blaylock?