Performance Improvement
Your RN tells you your patient is low risk but you feel the patient is SAFE. What do you do?
Communicate your concerns to your nurse and use your chain of command if necessary.
AFB sputum to rule out TB is collected in 3 separate samples, how many hours apart?
Minimum 8 hours but no more than 24 hours apart.
You placed patient in 201-1 back into bed after restroom assistance, what do you need to do before you move on to 201-2?
Remove gloves & perform hand hygiene.
You are sitter in a patients room, the family is visiting with patient and you really need to use the bathroom. What do you do?
Do not leave the room, call the RN or another CNA to relieve you. A patient's family cannot be left watching the patient.
Where do you document that the AFB sputum is collected?
Care board.
A Purewick needs to be checked how often for proper placement?
Purewick needs to checked Q2H and PRN for proper placement (Changed Q12H or PRN).
Patient does not have a BM on you shift, what is your responsibility to document?
Document zero output in BM at the end of your shift.
Bonus: Is this important to report to the RN?
When you hear a Code Red is paged overhead, what are you required to do?
Clear all hallways of equiptment/obstacles, close all doors to patient rooms.
Bonus Answer: Report to area the operator announces Code Red if your assigned duty on the shift. No need to take the fire extinguisher.
You are sitter during night shift. In the middle of the night, the patient is sleeping. You are feeling tired and sleepy too, what can you do?
Ask RN or CNA to relieve you for a break, if still tired after break report to Charge Nurse to have assignment changed.
What is the visible wet time for SuperSani Cloth vs Clorox Wipes?
SuperSani Cloth contact time is 2min, Clorox Wipes contact time is 3min.
You completed VS for the patient in 201-1, what do you need to do with the VSM before you move on to 201-2?
Bonus: Where do you store the VSM when your done with VS? (Should you ever store them in isolation rooms?)
Disinfect the VS machine.
Bonus answer: VSM machines should be stored in even number rooms and should never be stored in isolation rooms.
Drains: Demonstrate how to empty drain and how to document the output.
*Use Soarian Test site to demonstrate documentation
What are 2 examples of CNA shift responsibilities?
Code red, lift equipment battery change, break room, dirty utility, HIPAA, kitchen.
You are sitter in a patient room. You started to bathe your patient at 2245 and completed at 2310, but you missed documenting in real time the hourly check at 2300. When is it okay to back chart on the Continual 1:1 Observation Record?
If they were missed because actively performing patient care, never more than 1 hour back.
True or false: Oral care should be performed prior to sputum collection.
True.
Patient is discharged and your nurse tells you that they are ready to leave. Explain the process.
Bring wheel chair (if required) to patients room, place patient in wheel chair, take patient to central station or NW desk to have paper work HIPAA checked by Unit Secretary. Once paper work is checked, sign patient out on log with time, date and patients last name. (If in NW and no Unit is at desk, call Central station to inform of discharge)
You notice that a patient has broken skin or redness on the coccyx when you are changing their diaper. Your nurse never reported to you that the patient had a pressure sore. What do you do?
Press the call light to ask your nurse or CN to come in to see the patient. Nurse needs to take a picture if it is a new finding. And nurse will determine type of treatment appropriate for that wound.
Telemetry is discontinued- explain the new process.
Once telemetry is removed you have 15 min to physically return the telemetry box to ICU. Do not leave in nurses stations or in patient's room.
It is 0700 at change of shift, you are in the sitter room. What should you do with the complete 1:1 Observation Record? How can you obtain a new form for the next 24 hours?
The Continual 1:1 Observation Record is a 24hour form starting at 0700 to 0700 the next day. Place complete form in chart. Obtain new form with patients label from central station or NW station
Who's responsibility is it to update the care board throughout the shift?
RN and CNA (Physical Therapy & Speech also write their recommendations- DO NOT erase them)
Name 5 interventions for a High Risk Fall (SAFE) patient.
Bed exit alarm, Never leave alone in the restroom, SAFE bracelet, Nonskid socks, update Careboard.
You have patient that is on Tele and they are running A.FIB (Atrial Fibrillation)-how do you take the HR?
Take manual HR with a stethoscope and count for a full 60 seconds.
A patient is ripping off his restraints. What do you do?
Speak with the nurse and/or CN to discuss options.
Bonus answer: Blue restraints need special training to apply safety.
You come in to relieve the sitter at 1205 for their lunch break. Is there anything incomplete in their documentation?
*See handout provided
You are in the sitter room. If the patient is inappropriate and you want to document any comments, where do you chart this?
On the back of the Continual 1:1 Observation Record there is a portion where you can chart comments.