What should be completed in the patient's room prior to the patient arriving?
Bed zeroed
Essentials placed at bedside (toiletries, urinal, BP cuff, etc)
Suction set up
CARE channel on
How is a fall defined?
Unplanned lowering to the floor (or extension of the floor, e.g., trash can or other equipment) with or without injury to the patient
Why is measuring and documenting I&Os so important?
Medical conditions and medications can affect the patient's fluid balance. If the patient does not consume or excrete the appropriate amount of fluid, it can indicate a change in condition or that the patient is getting sicker.
What are the 6 Ps of Purposeful Hourly Rounding?
Presence
Pain
Potty
Position
Possessions
Privacy
Why is personal hygiene so important in the hospital?
Increases circulation, allows for skin changes to be noticed, decreases risk of infection and helps patient relax & feel comfortable
What are the PCNA's responsibilities once the patient arrives to the room?
Welcome and situate patient in room
Obtain patient vital signs and weight
Orient patient to room and unit
Inventory patient belongings
What are the three types of patient falls?
1. Physiological (fainting)
2. Environmental (slippery floor)
3. Assisted (another person attempts to minimize the impact pf the fall by lowering the patient to the floor
What are the types of output you are responsible for measuring?
Urine/stool
Drains (JP, Ct guided, NGT, chest tubes, other drains specified by the nurse)
What should you do if while completing your hourly rounds, your patient says they are in pain?
1. Acknowledge the patient's pain and inform them you will notify the nurse.
2. Notify the nurse
What does personal hygiene consist of?
Bathing and oral hygiene
Dressing patients
Washing and combing hair
Assisting patients with glasses and hearing aids
Who can assist with a dual skin inspection?
Nurses
PCNAs
Nurse Interns
How does a fall affect the patient?
Risk of injury
Longer hospital stay
Cognitive, emotional or functional impairment
Decreased quality of life
Increased co-morbidities
Death
Who should you reach out to if you are not sure how to empty a drain?
The nurse!
Ask the nurse if you have any questions or concerns
Where should you chart that you completed your Purposeful Hourly Rounding?
In the doc flowsheets under the treatment record
What is the preferred method of bathing a patient?
Use the pre-packaged wipes
Basins used for patient bathing are commonly contaminated with multidrug-resistant organisms, increasing the risk of hospital-acquired infections. Moreover, soap-and-water bathing causes skin deterioration in patients who are hospitalized, which can lead to pressure injuries
What is the process for using the Rover to photograph patient wounds?
Log into Rover
Select patient from list of scan the patient's wristband
Tap the camera icon near the top left of screen by the patient's profile picture
Tap "capture clinical media" to open the camera function. Active flash if needed?
The photo will not save to the patient's chart until you hit the green SAVE button
What are three risk factors that an increase a patient's risk for falls?
History of falls
Age of patient (elderly, infants, young children)
Cognitive impairment
Certain medications (pain, blood pressure, diuretics, laxatives)
Restless/agitated/confused
Weakness
Incontinence/frequency
Why would a 12 or 24 hour urine be ordered for your patient?
Hormones, proteins, and electrolytes are excreted in small, variable amounts in urine. Specimens for measuring these substances must typically be collected over an extended period to yield quantities of diagnostic value
You are rounding on your patients at noon. The patient in 506 is a q2 turn. You place 2 wedges under the patient's left side. What side do you chart the patient was turned to?
The right side
Where should you document that you performed personal hygiene on your patient?
In Epic!
Doc flowsheets -> treatment record
How do you inventory money? What do you do if they would like their belongings locked up?
Count the money or valuables with another person and document in the patient belongings flow sheet. Give yellow form to patient and take money envelope down to admitting or call MHPD if after hours.
What are the fall interventions for a LOW RISK patient?
Bed locked and in lowest position
Call light, telephone, bedstand within reach
Non-skid footwear
Use Assistive devices as needed
Use of top 2 siderails to facilitate mobility and transfers
Answer call light promptly
True or false: If a patient's urine is discarded while on a 24 hour urine collection, the collection must be restarted
TRUE
If a sample is discarded during the collection time, the process needs to be started over
Why is it important to complete Purposeful Hourly Rounding?
It is an established nursing best practice that leads to increased patient satisfaction, decreased call light usage and decreased risk for falls
All patients should have peri care performed at least daily. What type of patients is peri care especially important for?
Those patients that:
Have urinary catheters
Have had rectal or genital surgery
Are menstruating
Are incontinent of urine or feces
Are uncircumcised