IMPORTANT: The representative from Alaris will be on-site Tuesday-Thursday next week. The plan is for them to come to PICU and 7C on Wednesday (PICU around 1500, 7C around 1730). Many of you have already contacted me with questions and concerns, but if you have any questions/comments/concerns that you have yet to email me about, please do so by Tuesday of next week (April 2). This way, even if you aren't working, your question can be answered. I hope you are all using Guardrails for EVERY DRUG, EVERY INFUSION, EVERY TIME, including flushes- this way you know where the issues arise. Thanks everyone!
Erin
Friday, March 29, 2013
Employee of the Quarter
Hey everyone,
Please email me your Employee of the Quarter nominations by Monday, April 8th. Thanks!!
--Amelia--
Please email me your Employee of the Quarter nominations by Monday, April 8th. Thanks!!
--Amelia--
Documentation Reminders
7C Nurses,
I noticed a number of documentation issues this week during chart audits. Specifically, please remember to document pre and post pain scores when giving a pain medication. Also, please choose specific interventions in the Plan of Care section, it is not enough to just initiate certain choices (i.e. initiate Respiratory and not develop the actual care plan). Last, please remember to document ALL I/Os. There were several patients who had 12 to 16 hours with no documentation, and I know some of these patients are infants who must have had wet diapers. At the very least, document occurences for those patients who do not need strict measurements.
PICU Nurses,
Please remember to document pain reassessments every time.
Overall, documentation looks great. I want to note that admission assessments have been especially well done and complete. Thanks!!
--Amelia--
I noticed a number of documentation issues this week during chart audits. Specifically, please remember to document pre and post pain scores when giving a pain medication. Also, please choose specific interventions in the Plan of Care section, it is not enough to just initiate certain choices (i.e. initiate Respiratory and not develop the actual care plan). Last, please remember to document ALL I/Os. There were several patients who had 12 to 16 hours with no documentation, and I know some of these patients are infants who must have had wet diapers. At the very least, document occurences for those patients who do not need strict measurements.
PICU Nurses,
Please remember to document pain reassessments every time.
Overall, documentation looks great. I want to note that admission assessments have been especially well done and complete. Thanks!!
--Amelia--
Thursday, March 28, 2013
MUSC Nurse of the Year
Please vote for MUSC's Nurse of the year by following the link below. It is obvious that 3 of the 11 candidates are PICU nurses!! Let's help one of them win, we all know how wonderful the Peds Critical Care team is. Please VOTE and tell your friends!
Link to ballot - https://www.musc.edu/medcenter/nursing/noy/2013/ballot.htm
Link to NOY home page - https://www.musc.edu/medcenter/nursing/noy/2013/index.html
Monday, March 25, 2013
Kudos for Staff
Philip Schlabs was "GREAT" and Mary Carla London was "fabulous" per the 7C discharge phone call follow ups this past week. Way to go guys!! Thanks for taking such great care of our patients.
Nicole Daigle was recognized by Dr. Jason Buckley for being a great help on a crazy night in the PCICU. Way to represent, Nicole!
I also wanted to recognize Amelia Little and Erin O'Donnell for working together to improve our units. So much work goes on behind the scenes to keep things running smoothly and to meet our educational needs. Many of you have expressed thanks for Amelia and Erin in my rounding over the past month and I wanted to share this formally with them. You guys are Rockstars!
Thanks, Melinda
Nicole Daigle was recognized by Dr. Jason Buckley for being a great help on a crazy night in the PCICU. Way to represent, Nicole!
I also wanted to recognize Amelia Little and Erin O'Donnell for working together to improve our units. So much work goes on behind the scenes to keep things running smoothly and to meet our educational needs. Many of you have expressed thanks for Amelia and Erin in my rounding over the past month and I wanted to share this formally with them. You guys are Rockstars!
Thanks, Melinda
Education Update
Hi Everyone,
Last week I had been coming around to check everyone off on POCT, and I apologize for the inconvenience, but if you only performed one QC (high OR low) on the glucometer, you must do it again and perform BOTH the high and low QCs. Sorry- I was originally misinformed. Some of you mentioned that you were receiving expiration warning messages, and this could be why. If you perform both and you are still seeing those messages after a day or two, please let me know. I've been in contact with the POCT team and apparently there are some glitches in their system. Thanks for your patience.
There were no EROC topics for CH last week, so please take this week to go over the previous roll-outs (3 so far) if you have not done so already. There are several of you who have not signed them all, and last month's roll-out had some important information that you need to know.
Thanks Everyone!
-Erin
Last week I had been coming around to check everyone off on POCT, and I apologize for the inconvenience, but if you only performed one QC (high OR low) on the glucometer, you must do it again and perform BOTH the high and low QCs. Sorry- I was originally misinformed. Some of you mentioned that you were receiving expiration warning messages, and this could be why. If you perform both and you are still seeing those messages after a day or two, please let me know. I've been in contact with the POCT team and apparently there are some glitches in their system. Thanks for your patience.
There were no EROC topics for CH last week, so please take this week to go over the previous roll-outs (3 so far) if you have not done so already. There are several of you who have not signed them all, and last month's roll-out had some important information that you need to know.
Thanks Everyone!
-Erin
Wednesday, March 20, 2013
Safety Wednesday Update
As most of you know, every Wednesday, we are asked to stop and evaluate all safety issues on the units. This is done by the nurse manager who performs and audit of standard items like medication refrigerators, locked med rooms, HIPPA concerns, blocked corridors, etc. If any issues are found, I will follow up with the appropriate staff and charge RN and get them corrected.
I wanted to start taking this one step further and post a weekly Safety Wednesday Update on the blog. I will include any recent issues found and give a summary of the week's PSNs. We are all human and if one person can make an error, so can someone else. I want to be better at bringing you information in real time so we can correct issues in a more timely manner and continue to keep our patients safe. Please let me know if you find this information helpful.
Safety Wins for the Week:
1. Compliance with change of shift safety checks has been great. A mom (who is an RN) of a patient on 7C commented today how reassuring it was to watch the nurses do the safety check and to take the practice so seriously!
2. Kudos to Brooke Nitterhouse in PICU for realizing that pharmacy had stocked the wrong fluids in the Acudose. She prevented a potential error from reaching the patient!
3. High five to Nicole Daigle for doing a thorough shift change safety check and catching a medication error early in the PICU. She helped the patient and proved how important this practice is every shift!
4. Thanks to our NDNQI auditors who check each month for PIV infiltration and quarterly for pressure ulcers: Philip Schlabs from 7C and Karen Gilbert and Lisa O'Reilly for PICU.
5. Melinda is working on a plan with dietary to keep a floor stock of the pediatric enteral formulas so our RNs are selecting the correct enteral feed bag and we can eliminate the multiple errors and the wasted time when dietary sends the wrong enteral formula bag. Let me know if you have ideas for where we could store the formula bags!
Safety Opportunities for the Week:
1. Specimen Labeling: Please label at the bedside and have all specimens double checked with another staff member to ensure it is the right request and the correctly labeled tube.
2. Please remember when starting any high alert infusion, you must double check EVERYTHING with another RN. This includes the standard 5 Rights of medication administration: right patient, right drug, right dose, right time, and right route. In addition: you need to physically go to the pump for the double check and check the patient's weight (if wt based dosing), concentration, rate, and usage of guardrail against the MD order. Patient's weights may change so we need to be sure they are updated and accurate in the pump.
3. Please ensure your patient has written or electronic transfer orders before sending them to another floor. We had someone get transferred who was very ready to go, but the residents failed to write the orders.
4. Please remember to do your Fall Assessment each shift...and then comply with our Fall protocol if your patient is a Fall Risk. This includes putting the Fall Risk bracelet on the patient and the Fall Risk Sticker on the chart.
Finally, PICU has gone 37 months CLABSI free and has had no VAP or CAUTI this fiscal year! Unbelieveable!
7C has had no VAP for 2 years and one CAUTI in two years of being open!
Great job putting patient safety first!!! I am so proud of the dedication of each of you!
Melinda
I wanted to start taking this one step further and post a weekly Safety Wednesday Update on the blog. I will include any recent issues found and give a summary of the week's PSNs. We are all human and if one person can make an error, so can someone else. I want to be better at bringing you information in real time so we can correct issues in a more timely manner and continue to keep our patients safe. Please let me know if you find this information helpful.
Safety Wins for the Week:
1. Compliance with change of shift safety checks has been great. A mom (who is an RN) of a patient on 7C commented today how reassuring it was to watch the nurses do the safety check and to take the practice so seriously!
2. Kudos to Brooke Nitterhouse in PICU for realizing that pharmacy had stocked the wrong fluids in the Acudose. She prevented a potential error from reaching the patient!
3. High five to Nicole Daigle for doing a thorough shift change safety check and catching a medication error early in the PICU. She helped the patient and proved how important this practice is every shift!
4. Thanks to our NDNQI auditors who check each month for PIV infiltration and quarterly for pressure ulcers: Philip Schlabs from 7C and Karen Gilbert and Lisa O'Reilly for PICU.
5. Melinda is working on a plan with dietary to keep a floor stock of the pediatric enteral formulas so our RNs are selecting the correct enteral feed bag and we can eliminate the multiple errors and the wasted time when dietary sends the wrong enteral formula bag. Let me know if you have ideas for where we could store the formula bags!
Safety Opportunities for the Week:
1. Specimen Labeling: Please label at the bedside and have all specimens double checked with another staff member to ensure it is the right request and the correctly labeled tube.
2. Please remember when starting any high alert infusion, you must double check EVERYTHING with another RN. This includes the standard 5 Rights of medication administration: right patient, right drug, right dose, right time, and right route. In addition: you need to physically go to the pump for the double check and check the patient's weight (if wt based dosing), concentration, rate, and usage of guardrail against the MD order. Patient's weights may change so we need to be sure they are updated and accurate in the pump.
3. Please ensure your patient has written or electronic transfer orders before sending them to another floor. We had someone get transferred who was very ready to go, but the residents failed to write the orders.
4. Please remember to do your Fall Assessment each shift...and then comply with our Fall protocol if your patient is a Fall Risk. This includes putting the Fall Risk bracelet on the patient and the Fall Risk Sticker on the chart.
Finally, PICU has gone 37 months CLABSI free and has had no VAP or CAUTI this fiscal year! Unbelieveable!
7C has had no VAP for 2 years and one CAUTI in two years of being open!
Great job putting patient safety first!!! I am so proud of the dedication of each of you!
Melinda
Planned Electrical Outage This Weekend, 3/23 & 3/24
Please be aware that there will be planned testing of the emergency electrical power this weekend. This process will involve multiple "blinks" in the emergency power as they shift from generator to non-emergent power. The staff from physical plant and the electrical shop will be in house and ready to assist you in any way. Again, this will not be a continuous outage, but a series of blinks at different times in different areas. Charge RNs will be texted at 0700 and asked to send someone to pick up a radio from the North Tower Security Desk. Any urgent communication can take place with the command center over that radio. Prior to any blinks in your areas, the electricians will double check with the charge nurse to ensure that we are ok to proceed - i.e. no emergencies going on at that time.
All of our vents have battery backup. The RTs will be checking these Friday night. CVVH has no battery backup and should be moved to an outlet with non-emergent power prior to any blinks. We should not see any disruption in our equipment or care, but just wanted you all to be aware.
This will be the first of many planned electrical events and we replace the generator system for CH and Main Hospital. Our current system is very old and sits well below the flood plain....not a good plan when you live in Hurricane Country.
Please let me know if you have any questions. I am the manager on call this weekend if you need anything!
Thanks, Melinda
All of our vents have battery backup. The RTs will be checking these Friday night. CVVH has no battery backup and should be moved to an outlet with non-emergent power prior to any blinks. We should not see any disruption in our equipment or care, but just wanted you all to be aware.
This will be the first of many planned electrical events and we replace the generator system for CH and Main Hospital. Our current system is very old and sits well below the flood plain....not a good plan when you live in Hurricane Country.
Please let me know if you have any questions. I am the manager on call this weekend if you need anything!
Thanks, Melinda
TB Serum Shortage
Just an FYI—there is a national shortage of TB serum for PPD skin testing. Employee health will not be able to allot serum to individual units for staff testing. Employees will need to go to Employee health to get TB skin test/have it read before their expiration date.
Most of you will be due in June (please check your records as you cannot work if your test is not read by the deadline). I am uncertain at this time how long this shortage will last, just wanted to give you all a head's up. If they still have no serum to send to the units in June, we will have to plan ahead to ensure everyone can get over to employee health.
Thanks,
Melinda
Tuesday, March 19, 2013
GOOD NEWS!
PICU: Great job with the bedside safety checklists. As promised, you no longer need to fill out the paper checklist. You must, however, continue to perform the double check together and make a sticky note in your shift change check box in McKesson stating "bedside safety check complete". I will go back to daily audits and if I find more mistakes, we will go back to paper checklists. Thanks for your cooperation with this.
7C: Your turn! I will be rolling out shift-change checklists that need to be signed by both nurses during hand off starting tomorrow, 3/20/2013. The purpose of this checklist is to have both nurses checking the patient/alarms/equipment together to ensure the safety of our patients. I'll be here early for the rest of the week to introduce these, and answer any questions. I'll also be coming around daily to audit the checklists.
Thanks Everyone!
-Erin
7C: Your turn! I will be rolling out shift-change checklists that need to be signed by both nurses during hand off starting tomorrow, 3/20/2013. The purpose of this checklist is to have both nurses checking the patient/alarms/equipment together to ensure the safety of our patients. I'll be here early for the rest of the week to introduce these, and answer any questions. I'll also be coming around daily to audit the checklists.
Thanks Everyone!
-Erin
Monday, March 18, 2013
Patient Thank You Cards
In an effort to increase the amount of patient satisfaction surveys we receive, we have made patient Thank You cards. These cards have instructions about the follow up survey that families receive in the mail. The nurse or secretary can quickly fill it out and give it to the parents at the time of discharge.
PICU will keep the cards at the secretary desk on the black folder shelf.
7C will keep the cards at the secretary desk in a labeled folder.
Ask Carrie or Stephanie if you have issues locating the cards.
I know that we go through periods of time when we do not discharge many patients. However, this is exactly why we need to get every survey possible. If we only receive two surveys for a quarter, and one has low scores, it brings down our entire score very quickly. You guys do amazing things and deserve to get credit for the fantastic care you provide. Let me know if you have any questions.
--Amelia--
PICU will keep the cards at the secretary desk on the black folder shelf.
7C will keep the cards at the secretary desk in a labeled folder.
Ask Carrie or Stephanie if you have issues locating the cards.
I know that we go through periods of time when we do not discharge many patients. However, this is exactly why we need to get every survey possible. If we only receive two surveys for a quarter, and one has low scores, it brings down our entire score very quickly. You guys do amazing things and deserve to get credit for the fantastic care you provide. Let me know if you have any questions.
--Amelia--
Facebook Friendly Reminder - Everyone Must Read and Acknowledge
Facebook comments about your patients are strictly forbidden and a violation of HIPPA regulations. This includes commenting on posts by parents that make any reference to MUSC or that you are a caregiver for this patient. Best advice: Keep your personal and professional lives separate. Do not be Facebook friends with patients/families. The alternative is to explain to the families that it is our hospital policy to strongly discourage individual connection with patients on Facebook due to privacy concerns. Instead, encourage them to "like" the MUSC Children's Hospital Facebook page. They are free to post pictures or comments and the staff can see the progress of the patient/family at home.
This is EXTREMELY SERIOUS. Facebook is a PUBLIC forum and any posts or comments there are no different than you giving out verbal information about a patient. I do not have the authority to protect any of you for these violations. The discipline is cut and dry and usually immediate termination ordered by our compliance office and sanctioned by human resources.
On a similar note, you are forbidden to take photos of patients. If a parent wants to provide you with a photo, that is their choice. However, none of those photos should be made available to the general public, which includes your Facebook page. Again, the parents can post whatever they want, but if you are tagged and it shows up on your Facebook page, then it is considered that you are posting the photo....yet another reason to unfriend any patients/family members.
If you have questions, please contact me or Amelia. I would expect immediate discontinuation of any actions that are not compliant with the rules stated above.
I would like all staff on both units to comment back to this post that they have read it and understand fully.
Thanks,
Melinda
This is EXTREMELY SERIOUS. Facebook is a PUBLIC forum and any posts or comments there are no different than you giving out verbal information about a patient. I do not have the authority to protect any of you for these violations. The discipline is cut and dry and usually immediate termination ordered by our compliance office and sanctioned by human resources.
On a similar note, you are forbidden to take photos of patients. If a parent wants to provide you with a photo, that is their choice. However, none of those photos should be made available to the general public, which includes your Facebook page. Again, the parents can post whatever they want, but if you are tagged and it shows up on your Facebook page, then it is considered that you are posting the photo....yet another reason to unfriend any patients/family members.
If you have questions, please contact me or Amelia. I would expect immediate discontinuation of any actions that are not compliant with the rules stated above.
I would like all staff on both units to comment back to this post that they have read it and understand fully.
Thanks,
Melinda
Friday, March 15, 2013
F/U: Expirations for end of March 2013
7C and PICU:
This is your second reminder to complete any certifications that are due to expire at the end of March 2013.
March 2013
PALS cards not on file for: Kerry Bryers, Laura Smith and Lauren Mercede.
POCT testing for both 7C and PICU.
BLS
Marc Lindsey
PALS
Tiffany Mullins
TB
Krishna Woods
Please let me know if you have any questions.
Amanda
This is your second reminder to complete any certifications that are due to expire at the end of March 2013.
March 2013
PALS cards not on file for: Kerry Bryers, Laura Smith and Lauren Mercede.
POCT testing for both 7C and PICU.
BLS
Marc Lindsey
PALS
Tiffany Mullins
TB
Krishna Woods
Please let me know if you have any questions.
Amanda
Thursday, March 14, 2013
Inservice: Airway Clearance Guidelines
PICU RNs,
Jill Thompson and I will be holding inservices next Monday, Tuesday, and Wednesday mornings at 0700 to discuss the new Airway Clearance Guidelines we will be piloting in the PICU in April. I've emailed you all the powerpoints- please take a few minutes to look them over prior to the inservice so you can ask questions. Thanks Everyone!
-Erin
Jill Thompson and I will be holding inservices next Monday, Tuesday, and Wednesday mornings at 0700 to discuss the new Airway Clearance Guidelines we will be piloting in the PICU in April. I've emailed you all the powerpoints- please take a few minutes to look them over prior to the inservice so you can ask questions. Thanks Everyone!
-Erin
Wednesday, March 13, 2013
IV Bag/Tubing Change Reminder
PICU: Please remember that line changes are EVERYONE's responisbility. MIVF, med lines, IVPB and CVPs should be changed on day shift so night shift is not having to change everything. Night shift can aid in this effort by letting the day nurse know which lines are due to be changed during your safety check. Any questions or issues with this, please let me know. Thanks!
Erin
Erin
Tuesday, March 12, 2013
Purses Needed!
7C & PICU: Donate your gently used purses to Team MUSC's March for Babies Purses for Preemies!
Donations will be accepted through Thursday, April 11, 2013. The sale will be held on Friday, April 12 from 10:30am - 1:30pm.
You can drop off purses at the Children's Hospital Volunteer Office between the hours of 8:00am - 4:30pm, Monday - Friday OR you can drop off to my office during those hours OR you can place in/or under my mailbox in the staff breakroom. If you put purses near my mailbox, please put a note in my mailbox or email me to let me know I should look for purse donations.
Thanks for your help,
Amanda
Donations will be accepted through Thursday, April 11, 2013. The sale will be held on Friday, April 12 from 10:30am - 1:30pm.
You can drop off purses at the Children's Hospital Volunteer Office between the hours of 8:00am - 4:30pm, Monday - Friday OR you can drop off to my office during those hours OR you can place in/or under my mailbox in the staff breakroom. If you put purses near my mailbox, please put a note in my mailbox or email me to let me know I should look for purse donations.
Thanks for your help,
Amanda
Monday, March 11, 2013
Patient Safety Survey
As you are thinking about patient safety, consider some of the safety initiatives from the past year:
-PICU Shift Change Safety Checklist
-PEWS scores trialed on 7E and 7B
-Children's Hospital Safety Rounds
-Clarification of policy C-109, Chain of Command, and Lewis Blackman Policy
-PEARs class for floor nurses
-Children's Hospital New Hire Orientation
-Simulation lab training
-Standardized breast milk guidelines
-Bedside Shift Report
-Children's Hospital Practice Council
-Sitter policy revision
Hospital Survey on Patient Safety Culture Instructions
Survey open March 11th until March 25th
1. If you are a front line caregiver with direct contact with patients, you should have received a letter. On the envelope of this letter is the name of your service line and a random number. This number groups employees in groups no smaller than 10 people, to ensure anonymity.
2. In the letter, you will find a PIN number. Go to https://www.patientsafetygroup.org/survey/musc/
Let Amelia or Melinda know if you have any questions. Thanks!
Pay for 3/9/13 Night Shift - Daylight Savings Time
Attention to those who worked a "P" shift on 3/9: if you worked this night, you will only be paid for 11 hours due to losing an hour due to Daylight Savings Time. If you would like to use 1.0 hour of PTO to bring you to 12 hours for that shift, please remember to turn in a request for leave form. The payroll deadline is this Wednesday, 3/13 at 2:00 p.m.
Amanda
Amanda
Friday, March 8, 2013
Town Hall Dates and Times....Please try to attend
March 2013 Town Hall Series
| |||
Date
|
Day
|
Time
|
Location
|
3/6
|
Wed
|
2:00pm
|
ART Aud
|
3/7
|
Thurs
|
11:00am
|
ART Aud
|
3/7
|
Thurs
|
2:00pm
|
2 West Amp
|
3/8
|
Fri
|
10:00am
|
2 West Amp
|
3/12
|
Tues
|
10:00am
|
ART Aud
|
3/12
|
Tues
|
1:00pm
|
IOP Aud
|
3/12
|
Tues
|
2:30pm
|
2 West Amp
|
3/13
|
Wed
|
6:30pm
|
ART Aud
|
3/14
|
Thurs
|
7:30am
|
2 West Amp
|
3/14
|
Thurs
|
2:00pm
|
ART Aud
|
3/14
|
Thurs
|
2:00pm
|
2 West Amp
|
3/15
|
Fri
|
10:00am
|
2 West Amp
|
3/18
|
Mon
|
11:00am
|
ART Aud
|
3/18
|
Mon
|
1:00pm
|
CH Town Hall in Storm Eye Aud
|
3/18
|
Mon
|
2:00pm
|
2 West Amp
|
3/19
|
Tues
|
7:00am
|
ART Aud
|
3/19
|
Tues
|
10:00am
|
2 West Amp
|
3/20
|
Wed
|
6:30pm
|
2 West Classroom
|
3/21
|
Thurs
|
12:00pm
|
2 West Amp
|
3/26
|
Tuesday
|
1:00pm
|
CH Town Hall in Storm Eye Aud
|
EROC: Please sign by Friday March 22, 2013
Hey Everyone,
There are some really important updates rolling out this week. Please take the time to review each topic, sign here or in the binder, and email me with any questions. Thanks!
There are some really important updates rolling out this week. Please take the time to review each topic, sign here or in the binder, and email me with any questions. Thanks!
All Clinical Staff:
RN topics:
Announcements:
· Certified Nurses Day: March 19, 2013
Thursday, March 7, 2013
Reminder: Play Nice, Report Problems through Proper Channels
7C & PICU Staff,
Just a friendly reminder to please play nice with the other units. I know it can be very frustrating to receive a less than adequate report or have "critical" patients come up with no IV access, drinking a bottle, when they are being admitted for respiratory distress. I also know that sometimes others are intimidated by the critical care staff because we ask very thorough questions....even though we are not trying to be intimidating and are being great nurses and patient advocates. I PROMISE you, I will follow up on all of these cases to ensure all of our patients receive the best care throughout the continuum. Please just smile, be friendly, and make a note of the issues, patient name, MRN, and where they came from. If you will pass that information on to me or Amelia in a timely manner, we can follow up in real time. Please let me know if you have additional questions. I am particularly interested in patients who come in with no attempts at IV access when an IV is warranted by their diagnosis or condition.
You guys give awesome care and I don't want that to be overshadowed by any misconstrued behavior.
Thanks, Melinda
Just a friendly reminder to please play nice with the other units. I know it can be very frustrating to receive a less than adequate report or have "critical" patients come up with no IV access, drinking a bottle, when they are being admitted for respiratory distress. I also know that sometimes others are intimidated by the critical care staff because we ask very thorough questions....even though we are not trying to be intimidating and are being great nurses and patient advocates. I PROMISE you, I will follow up on all of these cases to ensure all of our patients receive the best care throughout the continuum. Please just smile, be friendly, and make a note of the issues, patient name, MRN, and where they came from. If you will pass that information on to me or Amelia in a timely manner, we can follow up in real time. Please let me know if you have additional questions. I am particularly interested in patients who come in with no attempts at IV access when an IV is warranted by their diagnosis or condition.
You guys give awesome care and I don't want that to be overshadowed by any misconstrued behavior.
Thanks, Melinda
Glucometer and iSTAT duties for Daylight Savings Time
Daylight Savings Time is Sunday March 10, 2013, all Point of Care Devices (i-Stat, Glucose meters) must be docked by the time indicated below to assure the patient results are posted to the electronic medical record without delay.
· Dock ALL glucose and iSTAT meters Sunday March 10th before 0150 and minimize testing on these instruments until after the time change, except in an emergency. ALL Meters should be docked again immediately after the time change; after 0301 EDT.
· All clinical areas that will be closed during Daylight Savings Time make sure that all devices have been docked before leaving for the day. After Daylight Savings Time please be sure to dock the meters before any patient or control testing begins.
Thanks,
Kimberly Q. Washington, MT (ASCP)CM
Medical University of South Carolina
Point of Care Testing
Kimberly Q. Washington, MT (ASCP)CM
Medical University of South Carolina
Point of Care Testing
Children's Hospital RM 336
(843)792-4007washikim@musc.edu
(843)792-4007washikim@musc.edu
Timeclock Downtime
7C and PICU - this applies to anyone working from 1900 on Saturday, 3/9 through 0600 on Monday, 3/11:
This weekend, Kronos (timeclock system) will be doing an upgrade on the software. They hope that the timeclocks will be working but just in case we're asked to be prepared for downtime.
If the clock is not working, then please print out and complete the attached time entry form: http://mcintranet.musc.edu/hr/payroll/pdf_files/TimeEntryForm.pdf
I apologize for the inconvenience - hopefully this will help some people who have been "rejected" lately by the time clock! :)
Amanda
This weekend, Kronos (timeclock system) will be doing an upgrade on the software. They hope that the timeclocks will be working but just in case we're asked to be prepared for downtime.
If the clock is not working, then please print out and complete the attached time entry form: http://mcintranet.musc.edu/hr/payroll/pdf_files/TimeEntryForm.pdf
I apologize for the inconvenience - hopefully this will help some people who have been "rejected" lately by the time clock! :)
Amanda
Nursing Checkbook - Charge RNs, please read!
As most of you are aware by now, we started a new process last week to document census and staffing every four hours. The tool used for this is called the Nursing Checkbook. Each charge RN is responsible for doing the documentation every 4 hours: 07-11-15-19-23-03. One problem we have noted in the documentation is that the charge nurses are being double counted in staffing. Please record the charge nurse under the CN category only. All other RNs should be noted in the RN section. For example, if you have one charge RN (even if they have patients), two other RNs, and on PCT, the charting should be as follows:
Census: # of pts
CN: 1
RN: 2
CNA: 1
You should also document the acuity in the comments section: like 1:1 patients in PICU and 1:2 patients on 7C. You may also put in road trips or any other event that impacts staffing in this section.
Please let me or Amelia know if you have additional questions.
Thanks so much! Melinda
Census: # of pts
CN: 1
RN: 2
CNA: 1
You should also document the acuity in the comments section: like 1:1 patients in PICU and 1:2 patients on 7C. You may also put in road trips or any other event that impacts staffing in this section.
Please let me or Amelia know if you have additional questions.
Thanks so much! Melinda
Wednesday, March 6, 2013
Education Tips
Hi everyone,
Just to clarify a few things that have come up recently:
1) Chemotherapy Drugs should come from pharmacy with an ORANGE CHEMO label, alerting us that ONLY chemo-certified nurses (7B) are permitted to administer these drugs. Hazardous medications like Ganciclovir, or the IL-2 given on 7C are labeled as Potentially Hazardous, and should be handled accordingly (Policy C-155 https://www.musc.edu/medcenter/policy/Med/C155.pdf) but do not require chemo-certification to administer. If you are uncertain, the 7B charge nurse is a great resource.
Regardless of hazard potential, please be sure to DOUBLE-CHECK all high-alert medications prior to administration, and co-sign in McKesson.
2) While on the topic of medication administration- There is a new hospital-wide initiative to improve the usage of Guardrails. There will be more info coming out of EROC this week, so look for it, but in a nut-shell: Every thing you run through a pump must go through Guardrails- every med, fluid, flush, etc. Any time you pick "Basic Infusion" it counts against us. Our Guardrails usage is currently at about 40%, our goal is 90%. The pharmacists have worked very hard to widen the libraries, and there is a form you can submit if there is a drug/concentration you can't find. Choices like NS carrier and PRBC's are being added to help this initiative. Again, more info to come, but please begin using guardrails EVERY time immediately. I can help submit requests for additions to the library, so email me if you're having trouble finding something.
3) Pre-mixed Formula bags that come from dietary (the ones we spike) are good for 48 HOURS. It has been our practice to change feed bags daily, but this is another way we can save time and $. Label the tubing when it is spiked, and it is good for 48 hours. Feed bags we fill ourselves will continue to be changed daily. Any questions, let me know.
Erin
Just to clarify a few things that have come up recently:
1) Chemotherapy Drugs should come from pharmacy with an ORANGE CHEMO label, alerting us that ONLY chemo-certified nurses (7B) are permitted to administer these drugs. Hazardous medications like Ganciclovir, or the IL-2 given on 7C are labeled as Potentially Hazardous, and should be handled accordingly (Policy C-155 https://www.musc.edu/medcenter/policy/Med/C155.pdf) but do not require chemo-certification to administer. If you are uncertain, the 7B charge nurse is a great resource.
Regardless of hazard potential, please be sure to DOUBLE-CHECK all high-alert medications prior to administration, and co-sign in McKesson.
2) While on the topic of medication administration- There is a new hospital-wide initiative to improve the usage of Guardrails. There will be more info coming out of EROC this week, so look for it, but in a nut-shell: Every thing you run through a pump must go through Guardrails- every med, fluid, flush, etc. Any time you pick "Basic Infusion" it counts against us. Our Guardrails usage is currently at about 40%, our goal is 90%. The pharmacists have worked very hard to widen the libraries, and there is a form you can submit if there is a drug/concentration you can't find. Choices like NS carrier and PRBC's are being added to help this initiative. Again, more info to come, but please begin using guardrails EVERY time immediately. I can help submit requests for additions to the library, so email me if you're having trouble finding something.
3) Pre-mixed Formula bags that come from dietary (the ones we spike) are good for 48 HOURS. It has been our practice to change feed bags daily, but this is another way we can save time and $. Label the tubing when it is spiked, and it is good for 48 hours. Feed bags we fill ourselves will continue to be changed daily. Any questions, let me know.
Erin
Tuesday, March 5, 2013
Staff Recognition
I have been rounding with staff over the last month and heard about all the great things everyone has been up to. I wanted to make sure the following people were recognized:
Angi Kemp recognized Jennifer Larkins for being a "worker bee", getting dirty, and always being willing to help. She also recognized Kelcy Strawn as being a fantastic orientee and someone who will be a great asset to the PICU team.
Brooke Nitterhouse wanted to compliment both Linette and Jennifer for always answering questions and being helpful. She also recognized Angi for being a fantastic preceptor.
Jen Bussey managed up Sheri Fannin for being a great mentor to the new staff and always being willing to help.
Jason Williams recognized Rachel Barber for being such a great preceptor (and so smart!) and Kelcy Scott for being an amazing tech. He is also mentioned that everyone has been welcoming and been great teamates.
Kelcy Scott complimented Rachel Barber, Natalie Ball, Randy (RT), Sheri Fannin, and Tiffany Mullins for all being willing to teach and answers questions.
Shane Crawford recognized Kate Seay in her new role as CUL. He said she is always willing to teach and is patient.
Kate Siegfried wanted to manage up Julianne Walsh for "running with it" on orientation and being so smart. She will be a great addition to 7C.
Julie Talor complimented Jennifer Larkins for being a great charge nurse and always being so helpful.
Lisa McCormick recognized Stephanie Mishoe for being an awesome and organized secretary. 7C is greatly for Stephanie every single day!!
Lauren Mercede managed up Kylie Weddington for quickly to pediatrics and being a great asset to 7C and the Children's Hospital.
Philip Schlabs and Mary Carla London were also recognized at this weeks Children's Hospital Patient Satisfaction meeting from survey comments.
I also wanted to take a moment to thank every staff member for being so welcoming, patient, and helpful to me in my new role. I feel very supported and can't thank you enough.
--Amelia--
If I missed anyone's recognition, or if you have a compliment to give, just comment on this post!
Angi Kemp recognized Jennifer Larkins for being a "worker bee", getting dirty, and always being willing to help. She also recognized Kelcy Strawn as being a fantastic orientee and someone who will be a great asset to the PICU team.
Brooke Nitterhouse wanted to compliment both Linette and Jennifer for always answering questions and being helpful. She also recognized Angi for being a fantastic preceptor.
Jen Bussey managed up Sheri Fannin for being a great mentor to the new staff and always being willing to help.
Jason Williams recognized Rachel Barber for being such a great preceptor (and so smart!) and Kelcy Scott for being an amazing tech. He is also mentioned that everyone has been welcoming and been great teamates.
Kelcy Scott complimented Rachel Barber, Natalie Ball, Randy (RT), Sheri Fannin, and Tiffany Mullins for all being willing to teach and answers questions.
Shane Crawford recognized Kate Seay in her new role as CUL. He said she is always willing to teach and is patient.
Kate Siegfried wanted to manage up Julianne Walsh for "running with it" on orientation and being so smart. She will be a great addition to 7C.
Julie Talor complimented Jennifer Larkins for being a great charge nurse and always being so helpful.
Lisa McCormick recognized Stephanie Mishoe for being an awesome and organized secretary. 7C is greatly for Stephanie every single day!!
Lauren Mercede managed up Kylie Weddington for quickly to pediatrics and being a great asset to 7C and the Children's Hospital.
Philip Schlabs and Mary Carla London were also recognized at this weeks Children's Hospital Patient Satisfaction meeting from survey comments.
I also wanted to take a moment to thank every staff member for being so welcoming, patient, and helpful to me in my new role. I feel very supported and can't thank you enough.
--Amelia--
If I missed anyone's recognition, or if you have a compliment to give, just comment on this post!
Monday, March 4, 2013
NEW and IMPORTANT!
Due to several patient safety issues regarding tubes and drains recently, the Patient Safety team has decided we need to start labeling ALL TUBES and DRAINS. This includes NG Tubes, G-Tubes/J-Tubes, Chest Tubes, JP Drains, Foleys, Ventrics, Nephrostomy Tubes, etc. We can use the grey "OTHER" labels that can be found with the IV labels if the device does not come with its own. Please label with the type of device, and the date of insertion (for Mic-Key GT/JT extensions, the date opened and connected). The Patient Safety team will be auditing us to make sure we comply. I will also round daily to remind everyone since this is new for us. Any questions, please let me know. Thanks Everyone.
Erin
Erin
FYI
IMPORTANT - Medication Supply News
► Dextrose 50% Abbojets have recently been on backorder and have become an unsustainable supply at this time. Dextrose 50% vials, however, are available.
► Each unit’s Acudose has now been converted to the vial dosage form.
► The few Dextrose 50% syringes that are available will be sequestered for the orange tackle boxes for use during a code.
o I.E. - Only use the D50 in the orange tackle box during a code
► In non-code situations, use the supply available in the Acudose. A syringe will be needed to draw up the medication.
o I.E. - Do Not use the orange tackle box supply for non-code situations
2013 Nurse of the Year Nominations are Open
With all the talented staff we have in PICU and 7C, I know we can nominate some of our peers for Nurse of the Year! See below for instructions on how to nominate someone. Thanks, Melinda
Each year MUSC honors the "Nurse of the Year." One winner will be selected from nominations submitted, which may include nurses employed in any capacity (for example, Staff Nurses, Nurse Managers, Resource Nurses).
Requirements for all nominees:
1. The nominee must be a registered nurse in current position for at least one year.
2. The nominee must be respected and admired by patients, families, co-workers and students.
3. The nominee always adheres to MUSC Standards of Behavior.
4. The nominee cannot be in current disciplinary action.
5. The nominee is employed by MUHA in a permanent position.
All nominations for Nurse of the Year are to be submitted online and must be received by noon March 14, 2013.
NOY Information and timeline –
NOY Process –
NOY Nomination Form –
Sent on behalf of
Rebecca A. Cherrington MSN, RN
Nurse Alliance Chair
and
Amelia Little, BSN, RN
Nurse Alliance Chair-Elect
Patient Safety Week
FYI: Monday 3/4 - Friday 3/8 there will be various events to celebrate Patient Safety Week.
Monday:
Night Shift Safety Fair in the ART Mezzanine 0700-0800
"Removing Communication Barriers" 2 West Amphitheater 1300-1400 (free food to first 50 people!)
Tuesday:
Tables with Education and FUN in ART lobby and North Tower Lobby 1100-1400
Wednesday:
Tables with Education and FUN in ART lobby and Children's Hospital Lobby 1100-1400
Infection Prevention Short Stories in the Storm Eye Auditorium 1200-1300
Thursday:
Patient Safety Fair featuring FOOD and FUN in the MUSC Horseshoe 1100-1400
Friday:
Night Shift Safety Fair in the 2nd floor connector between Children's and the garage 0700-0800
Tables with Education and FUN in Rutledge Tower Lobby 1100-1400
Monday:
Night Shift Safety Fair in the ART Mezzanine 0700-0800
"Removing Communication Barriers" 2 West Amphitheater 1300-1400 (free food to first 50 people!)
Tuesday:
Tables with Education and FUN in ART lobby and North Tower Lobby 1100-1400
Wednesday:
Tables with Education and FUN in ART lobby and Children's Hospital Lobby 1100-1400
Infection Prevention Short Stories in the Storm Eye Auditorium 1200-1300
Thursday:
Patient Safety Fair featuring FOOD and FUN in the MUSC Horseshoe 1100-1400
Friday:
Night Shift Safety Fair in the 2nd floor connector between Children's and the garage 0700-0800
Tables with Education and FUN in Rutledge Tower Lobby 1100-1400
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