The Basics
When would you use soap and water instead of hand sanitizer?
How long should you wash your hands?
Hand washing should last 20 seconds. Hand sanitizer should be until dry.
When should you send a medication order to the MD?
OTC meds, discontinued meds
You do not send if a new med is found in the home in a prescription bottle.
What should be on a lab tube and lab order form?
All Clinicians to fill out a tube and form
name, dob, address of patient, phone number, md (first and last name), date and time collected, insurance, how obtained, who obtained, dx code(s) and what labs are ordered
make sure to check box for us to get results
The MD
no changes should be made to size of catheter or frequency without MD order
How often should a PICC line dressing be changed?
once weekly
How many pockets are on the bag and what are they for?
6 pockets.
Pocket 1- clean and reusable items
Pocket 2- dirty or disposable items
Pocket 3- clinicians personal use
Pocket 4- PPE
Pocket 5 and 6- hand hygeine/sharps biohazard box
What medication issues would you call the MD for?
meds not in home
not taking as prescribed
interactions between meds and supplements
can't give meds
can't afford meds
can't access meds
(should also request MSW in most of these cases)
What is the proper way to dispose of used sharps?
in the amedisys approved and provided sharps container
when full, should be brought to the office for disposal
Is a foley change a sterile or aseptic technique?
sterile!!!
Everyone to demonstrate sterile technique :)
Yes
How often should vitals be obtained?
What vitals are we responsible for in HH?
every visit and with changes in patient status
BP, pulse (manually), O2 sat, temperature, respirations
When should medications be reviewed?
at SOC and every single visit
side note: we should educate on at least one medication every visit and it should be documented in the narrative
side note: if on Coumadin, who is managing???
Who should be notified and when should be notified that we obtained a PT/INR.
CM and MD should be notified.
Who was notified should be documented in the narrative along with the PT/INR results as well as the current dose of Coumadin.
How do you collect a specimen from a catheter during a cath change? Not during a cath change?
Please demonstrate :)
sterile
When should you call the MD?
vitals outside parameters
patient status change
falls
for new orders
at SOC
Non- admit
What are the signs and symptoms of Coumadin toxicity?
excessive bruising, nose bleeds, bleeding gums, blood in urine/stool
side note: this should be included in the narrative on every single patient that is on coumadin. we should be educating and checking for these s/s every visit.
Where should labs be dropped?
Ballad Hospitals
side note: CMs should be notified of when and where labs were dropped. It should also be in the narrative.
How many times can a foley be used?
once, we should never retry insertion with the same foley we failed with. If a foley gets contaminated and sterile procedure was broken a new foley should be used.
How long can we use a peripheral before changing?
72 hours
Can vital sign parameters be patient specific or are they all the same?
They are patient specific. If patient is consistently out of range, the MD may want to change them.
i.e. patient is always in the 50's for HR, but parameters are 60-100. Call MD, they may want to lower so they don't get called every visit.
Who is allowed to pick up and transport patient medications?
ANYBODY BUT US
NO EXCEPTIONS!!!
What are the blood glucose parameters per Amedisys policy?
70-300
Can people other than Amedisys employees assist or perform foley changes?
NO!
What should be in an order for IM injection?
medication, route, dosage, frequency, reconstitution details, MD ordering and who should be performing
side note: this should all be in the narrative as well