Emergency Standards
How do you call RRT (Rapid Response Team)
7-5555
You are giving a Heparin Infusion, and a second nurse verification is required. What steps need to occur and why?
physically look and verify the medication, MAR, and pump
Policies:
Medication Administration Nursing (GC Market) v.6 (policytech.com)
High Alert Medications (SE Region) v.3 (policytech.com)GC Market) v.6 (policytech.com)
Safe medication administration practices, general: Lippincott Procedures
How do you call security?
panic button or 704-355-3333
Name 2 common sources/reasons of lawsuits in healthcare?
Give 2 examples of Workplace Violence.
Verbal, physical. Involves a Patient, Visitor or Teammate. Racial/cultural Slurs, threats, bullying, shouting ect.
What mnemonic is used to identify a stroke?
BEFAST
Vitals were completed at 730am (HR 95 & BP 126/78), and you need to administer Lopressor at 930am. Should you receive a new set of vitals before administering the Lopressor, and why?
Yes, because best practice is to obtain a set of vitals within 1 hour before administering any medications with (vital sign) parameters.
Define the difference between non-violent and violent restraints.
Non-Violent: associated with non-destructive behavior. Applies to non-violent safety needs that impact or have the potential to impact the patient (interference with medical devices, attempting to ambulate/move/transfer with no regard to deficits).
Violent: Used for severely aggressive, violent, or destructive behavior that presents an immediate, serious, danger to the safety of the patient, teammates, or others and requires rapid assessment and intervention. Includes chemical restraints, mechanical devices, seclusion, and physical holds.
Should a teammate make a note in the chart that a "care event" was completed?
No: Do not Chart
•Gaps in medical record
•Vague descriptions or explanations
•Charting “blame”
•Charting that a Care Event was done
•Untimely documentation
oAnd inappropriately timed entries
DO NOT CHART
•No distress noted
•Patient encouraged to…
•Verbalized understanding…
•No c/o…
•Will continue to monitor…
A patient was found on the floor attempting to go to the bathroom on their own. What form is needed to be filled out? (hint: NOT a Care Event)
Post fall huddle form
If a teammate or visitor is complaining of chest pain, what do you do?
Call RRT for a visitor/teammate
Due to ED response, it is important to distinguish. Especially if a pediatric patient is involved.
If they refused to go to ED, put in a Care Event
What resource do you have to use to look up a medication you are unfamiliar with?
Micromedex: to review indications, incompatibilities (fluids), recommended monitoring, and common side effects.
What does the "Blue Star" OR the "Orange Triangle" sign stand for?
Is a Visual Alert to heighten awareness of potential for risk to harm through the use of a visual que. Serves to notify healthcare personnel to take precautions upon entering the patient's room.
What does it mean to chart in real-time and why is it important?
To ensure the accuracy of the information and to reflect ongoing care. Delayed documentation increases the potential for omissions, error, and inaccuracy from memory lapse. Never chart in advance.
Other Considerations:
•Document only care, treatments, and medications that you've actually provided or administered
•Describe observations and behaviors of the patient rather than label the patient. Don't offer opinions or use subjective statements or judgments.
•You can always add a comment
•Notes are visible in MyChart so maintain professionalism
What is alarm fatigue?
Becoming desensitized to safety alerts, and as a result clinicians tend to ignore or fail to respond appropriately to alarms.
Who can initiate the code blue process?
ANYONE who is a BLS provider. Check for a pulse and breathing. IMMEDIATLY start compressions.
Hit the code blue button on wall, call 7-5555
What is Tall Man Lettering, and why is it important?
(DOPamine vs. DOButamine) To help distinguish between medications with similar names. Medication Safety.
Policies:
Medication Administration Nursing (GC Market) v.6 (policytech.com)
High Alert Medications (SE Region) v.3 (policytech.com)GC Market) v.6 (policytech.com)
Safe medication administration practices, general: Lippincott Procedures
Mr. Smith is calm and sleeping in his bed with his soft wrist non-violent restrains on. You want to give him a trial period without the restraints. Is this acceptable and why?
No, it is against policy. Patients either meet or do not meet criteria for restraints.
You need to discontinue the restraint order and chart the discontinuation for the same time.
The order must match the behavior and the restraint on the patient.
There is no such thing as a prn order.
List 2 purposes of documentation.
•Evidence of Quality of Care
•Ensures continuity of care
•Performance Improvement
•Reimbursements
•Legal Protection
Reflects:
•Professionalism
•Competence
•Compliance
1 reason why it is important to submit Care Events.
Help our organization understand where gaps in care are present and where improvements are needed
Decrease unintended harmful events from reaching our patients and teammates
Increase transparency among teammates, clinicians, units, and practices
Real – time error detection and prevention
Higher teammate engagement
Supports a culture of high reliability and achieve our goal of ZERO HARM FOR ALL
You have a patient who is coding (Code Blue) and is on isolation precautions. What do you do FIRST before helping them?
Put on the appropriate PPE
What is a Best Practice Advisory (BPA) (Hint: It's a Red or Yellow) and what are your next steps when it populates?
A BPA is a notification that populates if there was an error in charting, or if the teammate needs to complete something before continuing on. (i.e. heparin dose does not match the dose from the calculator, MRSA screening needs completed). EBP for safety and quality.
Complete and correct before moving on, do not override.
When are mitts considered a restraint?
Mitts are considered a restraint when they are secured (tied) to the bed and/or when the patient is unable to utilize their hands. "You are restricting the use of their hands/fingers".
Thus - if the mitts are velcro so tightly around the wrist that the patient CANNOT remove the mitt, it is a restraint.
What is Legal Lighthouse on People Connect?
Legal Lighthouse contains resources to help navigate frequently-encountered legal issues in treating and interacting with patients
Except as otherwise noted, the guidance is based on North Carolina law
You assisted a patient into the bathroom, when another patient's bed alarm starts going off. What are your next steps?
Stay with the patient in the bathroom. It is everyone's responsibility to answer and respond to bed alarms.
"Own the Zone", even if it is not your patient, you have a duty to respond.