Medication Reconciliation (BPMH)
When should the initial medication reconciliation be completed?
Within 24 hours of seeing the physician.
Name 3 out of 5 care transitions.
Admission, Handover, Transfer internally, Transfer to external site (hospital), Discharge
What do we use at RFHC to identify equipment that has been cleaned and disinfected?
Green Means Clean - "I am clean" sticker
Within ____ hours of admission clients are screened for falls risk.
24
What tool do we use to assess suicide severity at RFHC?
Columbia Suicide Severity Rating Scale (C-SSRS)
When should Medication Reconciliation be completed?
Admission, transfer, discharge
Who completes care transitions?
The entire team! (nurse, health care worker, doctor, social work, occupational therapist, NUA, pharmacist, & more)
Name 4 different equipment items that is included under Green Means Clean initiative.
(1) Vitals machine, (2) Breathalyzer, (3) Thermometer, (4) wheel chair, (5) 4 and 2 wheel walker, (6) Glucometer, (7) AED, (8) floor mats, (9) Seizure side rail pads, (10) mobile work station, (11) crash cart
You've identified a client is at risk of falls, what interventions do you put in place to communicate this? (identify at least 3)
Green magnet, process alert in banner bar in Cerner, Morse falls prevention in iView, Care plan, Non-slip socks, Fall precaution equipment (wheel chair, 4 or 2 wheel walker, etc.), Verbal communication with team, documentation.
Who can complete suicide assessments? (Name minimum of 2)
Physicians, nurses, allied health professionals who offer clinical care to clients.
What do we use BPMH for?
To communicate accurate and complete information about medications across care transitions.
Why do we complete care transition documentation?
What does "contact time" on disinfectant supplies mean?
The time the equipment must remain wet after disinfecting.
Someone who may use furniture as a guide, walks in short steps and may shuffle would have a gait of Normal, Weak or Impaired (as defined by Morse)
Weak
• Stooped, can lift head without losing balance
• May use furniture as a guide, with a feather weight touch
• Short steps, may shuffle
When is suicide assessment and monitoring completed?
Full suicide assessment screen is completed on admission.
Frequency of assessments is based on risk level: low, moderate, high.
Pharmacists. If none on site GP/NP.
What are 5 examples of documentation at care transitions?
Referral package, referral summary, CST Cerner, Admission task form, Transfer task form, Kardex, Team communication, Discharge checklist, MRR.
When are the four moments of Hand Hygienne?
Before initial contact
Before aseptic procedure
After body fluid exposure
After contact with the client
44 and under = negative screen
45 and higher = positive screen
Name the difference between Low, Moderate and High Risk Assessment
Low: no method, no plan, no intent, no suicidal behavior in past 3 months.
Moderate: has thoughts with method, no plan, no intent, no suicidal behavior in past 3 months.
High: has suicidal thoughts with intent (with or without plan) OR has had suicidal behavior in past 3 months
How does medication reconciliation work?
prescriber uses the BPMH and the current medication orders to generate transfer or discharge medication orders.
Complete an SBAR.
Situation
Background
Assessment
Recommendation
Explain the proper order for donning.
(BONUS: PROPER ORDER FOR DOFFING)
Donning: hand hygiene, gown, mask, goggles or face shield, gloves.
BONUS: Doffing: gloves, hand hygiene, gown, hand hygiene, goggles or face shield, hand hygiene, mask, hand hygiene
According to the policy and procedure, What are the three types of Adult Falls in Cerner?
Anticipated physiological (has condition that predisposes them to falls)
Unanticipated physiological (has physiological reason for fall but is unanticipated)
Accidental (no physiological reason for fall, but falls nonetheless)
What are 5 duties a clinician must complete if a client expresses suicidal ideation with method, but NO plan, NO intent, and NO suicidal behaviors in the past 3 months. (BONUS 50 POINTS IF YOU CAN IDENTIFY RISK LEVEL)
(1) contact psychiatrist, (2) complete C-SSRS qshift, (3) ongoing review and assessment, (4) hold all passes until assessed by psychiatry, (5) conduct regular room searches, (6) update Kardex, (7) update care plan, (8) document on EHR.
(BONUS 50 POINTS: MODERATE RISK)