Patient Transfer Times

- Mandatory for everyone to read and reply that you have read on the blog

Please remember that we have set times for transfers in and out of the PICU and to both 7C and PICU from the PED.

From any floor to PICU:  patient must be arrived within 30 minutes of the bed being ready (and we should always be ready unless we are full or a patient just left and the bed is not clean).

From PICU out to any floor:  One hour

From PED to PICU or 7C:  One hour

This may seem like an unimportant issue.  However, failure to comply with this process impedes bed flow and can increase our cost and decrease our productivity.  In the past week, WE HAD 15 TRANSFERS OUT OF PICU AND ONLY 5 OF THEM LEFT IN A TIMELY MANNER.  This is absolutely unacceptable and I will be tracking each transfer and any delays will have to be explained or disciplinary action will occur.  I had mistakenly assumed we were just putting in for beds in the morning before we knew the patients were leaving for sure, but that is not the case.  The CULs have been waiting to put in the beds until the orders are written.  Then, once we have a bed, the staff is still not getting the patients out within one hour.  We now have to be part of an IMPROVE process to ensure better compliance.

RNs, please do not put in a bed request until you have orders written by the resident and know for sure the patient is going.  With the diabetics, the transition orders are written at the same time as transfer orders, but do not put in the request until you know the patient has tolerated the transition and is truly ready to leave.

Please remember the clock does not start ticking until the bed is available and ready.  There are few reasons we should not be meeting this policy.

Please let me know if you have questions.

Thanks, Melinda

PICU patients going to OR

Effective immediately- Anesthesia will now pick up patients in PICU and receive bedside report then take patients down to the OR.  We will no longer take our patients to the front desk.  This will ensure a thorough report is given and the patient is handed off safely.  To expedite this process, please complete the pre-op checklist as soon as possible (nightshift for those scheduled in the AM).  Let me know if you have any questions.

Erin

Evidence-Based Practice Workshop

Center for Evidence-Based Practice & Center for Professional Excellence Present

Evidence-Based Practice Nurse Scholars Course:

a project-based workshop for nurses on integrating evidence into practice

COURSE DESCRIPTION: The Evidence-Based Practice (EBP) Nurse Scholars Course at the Medical University of South Carolina (MUSC) is designed to teach EBP skills that will enable staff to conduct extensive evaluations of existing literature to improve patient care. The program provides a comprehensive overview of EBP. During the course, EBP Scholars will choose a policy or practice change requiring EBP evaluation, and focus on reviewing the evidence for the policy or practice update.

CLASS MEETING TIMES: This 12-week, project-based workshop will be held on Thursdays from 1-2:30 pm from Feb 13th – May 15th. (NOTE: There will be a 2 week break. No sessions will be held March 20th or April 17th).

COURSE OBJECTIVES: Upon completion of this course, participants will be able to:

1. Distinguish EBP from research and quality improvement.

2. Discuss the 5 steps used to implement EBP in a clinical environment.

3. Explore search engines used to identify appropriate EBP articles and reviews.

4. Develop skills in evaluating the evidence and synthesizing the findings.

5. Develop expertise in summarizing evidence specific to a nursing policy/practice.

6. Determine appropriate measures to evaluate the effectiveness of EBP implementation.

7. Disseminate evidence to support a specific nursing policy or practice update.

REQUIREMENTS AND CREDIT: 18 hours of nursing CE credit have been applied for. Participants will need to attend at least 10 of the 12 sessions, and complete an evidence-based summary for their selected nursing policy or practice change in order to receive credit. Participants will be able to use these projects for RN III certification.

THE BENEFIT: Past course participants have used their course projects to change the way care is delivered at MUSC through updating current policies and education material, and developing standing orders and protocols. Several have developed poster abstracts and presented their work at national conferences. The work from this course will lead to opportunities for scholarly publications.

CONTACT FOR QUESTIONS AND TO REQUEST AN APPLICATION: Please contact Andrea Coyle (coyla@musc.edu, 792.7769) or Elizabeth Crabtree (crabtr@musc.edu, 792.4348) with any questions, or to request an application. Application deadline is January 6th. Selected applicants will be notified of their acceptance by January 20th.

Nursing contact hours provided. The Center for Education and Best Practice of MUSC Health is an approved provider of nursing continuing education by the South Carolina Nurses Association, an accredited provider by the American Nurses Credentialing Center's Commission on Accreditation



Safety Reminders

Please remember to check your alarms during shift change: the high, low and critical alarms should all be checked Q shift. A patient was desating without critically alarming (the loud beep that needs to be physically silenced) because it was set abnormally low. If you need assistance with this, please let me know.


When caring for trached patients, checking the trach box is part of your bedside safety check. Last week a trached patient in PICU was missing several emergency supplies, including the smaller sized back-up trach. With respiratory season upon us in full swing, please get in the habit of checking these things. Each trached patient should have a designated BOX (pink basin) marked TRACH SUPPLIES, and this box should not be used for anything else. Feel free to ask the charge RN or PCT to gather your trach supplies and box if you are busy with your patients.

7C- Please remember that Bedside Shift Report should be done at the bedside. The 7C nurse's station is busy in the morning with RNs, MDs, and other team members, so the bedside is the best place to give and receive a clear, thorough report. This allows you to immediately perform your safety checks and also allows the charge RNs to give and receive report without others speaking around them.

A HUGE shout-out to both units for your hard work this month. It has been very busy, and many of you have been open and flexible with assignments and shifts. Thank you for your positivity! It is vital during busy times, and does not go unnoticed. If you notice a staff member going above and beyond, please remember to recognize them. Tell myself or Melinda, nominate them for employee of the quarter, or a DAISY award. We work with some pretty great people who deserve to be recognized for it :)

Any questions/comments, please let me know.

-Erin

    

STAFF MEETINGS

We will be having STAFF MEETINGS on:
Thursday November 21 and Friday November 22 at 0730 on 7C
Monday November 25 and Tuesday November 26 at 0730 in PICU
Please plan to attend. 

EROC Updates. Please sign here or in binder by Friday November 22.

Compliance: Patient Information on computers: I will do my best to speak to everyone about this. It is very important to log out of McKesson and Oasis if you are leaving your computer. Audits are being done by the compliance team and anyone found to be non-compliant will be reported for disciplinary action. It is unfortunate that it has come to punishment, but HIPPA regulations require us to keep patient information private. In EROC we were told that minimizing the screen is “ok” but logging off or locking the screen are better options. Those found with minimized screens will not be reported, but may be asked to log off/lock in the future. If you are at the bedside (PICU) you do not need to log off, but remember to do so before leaving the bedside to get supplies, meds, or see your other patient. Please let me know if you have any questions or concerns, I really don’t want any of you getting in trouble for this. You take excellent care of our patients and deserve recognition for your dedication, not punishment for simple mistakes. End of rant.


Pre-Op Checklist

Power Point

Quick Tips

CAUTI Updates: We have had 3 CAUTIs already this year. I am planning a CAUTI Bundle class for next week, stay tuned.

3M Tegaderm

Shortage of Heparin Tubex: We rarely use these, but please be aware of the change in case the wrong vials are mistakenly placed in our accudose. Check your concentration.

Pediatric Trauma and Injury Prevention Symposium

FYI- this conference was great last year, and this year it is here!  Let myself or Melinda know if you're interested, we can definitely offer education time for this.

Daylight Savings Time: POCT

Please dock all iStats and glucometers by 1255 AM Sunday morning (Saturday nightshift).  If possible, do not use these devices for 65 minutes (after the time change when 0200 becomes 0100).  If they must be used, do not re-dock them until after the time change so the data can be uploaded with the correct time. 
Thanks!
Erin

Certifications that are due to expire within the next 30/60/90 days

Please check this list for your name to see if you have any required certifications that are due to expire within the next 30/60/90 days.

November 30th
 PALS: Amy Russell

December 31st
BLS: Kylie Weddington

January 31st
BLS: Kelly Grommersch
          Mary Carla London
          Amy Russell

 RES FIT: Lindsay Amerman           Shane Crawford
                 Emily Dorman                 Jessie Green
                 Kelly Grommersch          Mary Carla London
                 Karen Loury                     Kelli Masters
                 Lisa McCormick              Anna Mechem
                 Lauren Mercede               Amy Russell
                 Kate Santos                      Philip Schlabs
                 Kate Siegfried                  Amanda Smith
                 Trellar Terry                     Julianne Walsh
                 Kylie Weddington