Room supplies

Bag 1 supplies: Nasal cannula, oxygen extension, tubing connector, Venti mask, and 100% NRB
Bag 2 Supplies: Yankeur Suction, Suction Catheter kit, suction tubing, 80 mm oral airway,
90 mm oral airway, & 100 cm oral airway

1. Above you see pictures of 2 bags that will be at hand at each patient's bedside.
2. If you open the supplies for a patient they are only to be used for that patient for the duration of their stay.
3. Housekeeping will be wiping off the bags if they are not opened but if the seal is opened then the bag "belongs" to that patient.
4. New supplies in a new bag will be replaced if the bag is opened for a prior patient.
5. I expect that the suction cannister if used will be replaced in the room other wise housekeeping is only wiping down the exterior surfaces of everything.
6. This is in an effort to decrease patient exposure especially given the volume of isolation patients we see on a daily basis.

Thanks for your help in keeping our patients safe.

Tracy

Question for you

Your diabetic patient is to receive Tenormin (Atenolol) this morning.
As her nurse you should assess which lab value:
a. Glucose
b. Potassium
c. Calcium
d. Magnesium

{courtesy of David Woodruff Med/Surg Certification Review}
Answers can be posted here or email.

We appreciate all you do!

The Lady With the Lamp National Nurses Week is always May 6-12, ending on Florence Nightingale's birthday. National Nurses Week is always May 6-12, ending on Florence Nightingale's birthday. By ADVANCE staff
Test your knowledge about the founder of modern day nursing with some of these lesser known facts:
Nightingale's father was a pioneer in epidemiology and tutored Florence in mathematics/statistics, an area she excelled in later in her career.
A gifted statistician in her own right, Nightingale was fond of using pie charts when presenting her statistics.
Among many studies, Nightingale did a statistical analysis of sanitation in India.
Nightingale was the first female to be elected to Royal Statistical Society.
Florence Nightingale defied her extremely wealthy family and upper class conventions in choosing to become a nurse in 1845.
Nightingale not only fought for better medical care, but also championed social issues such as reform of the British Poor Laws.
Nightingale's first published work was on a German Lutheran religious community in 1851.
Most famous for her care of soldiers during the Crimean War, Nightingale entered Turkey in 1854 with 38 nurses she personally trained.
In Nightingale's first winter at Scutari in the Crimea, the death toll rose with more than 4,077 soldiers dying.
Nightingale's first evidence-based practice research involved collecting evidence that poor living conditions were the cause of most soldier deaths during the Crimean War.
The Times of London is widely considered responsible for labeling Nightingale "the lady with the lamp."
The U.S. government consulted Nightingale on setting up military hospitals during the Civil War.
As a woman, Nightingale could not serve on the British Royal Commission on the Health of the Army even though she played a critical role in its formation.
What is now the Florence Nightingale School of Nursing and Midwifery, part of King's College London, was established by her to train nurses in 1860.
Notes on Nursing also sold well as a popular book in the 1860s.
In 1867, poet Henry Longfellow's poem "Santa Filomena" further ensured Nightingale's image with the lines, "Lo! In that hour of misery A lady with a lamp I see Pass through the glimmering gloom."
In the 1870s, Nightingale trained Linda Richards, the first formally trained American nurse.
Nightingale died in 1910, but her family declined to have her buried in Westminster Abbey with kings, queens and other English nobility. She is buried in the churchyard at St. Margaret's Church, East Wellow, Hampshire, England.
Nightingale's maternal grandfather was the British abolitionist Will Smith.
Nightingale is named after her birthplace, Florence, Grand Duchy of Tuscany (Italy).
To read more about Florence Nightingale and her continuing influence on nurses, see this selection of editor's picks from the ADVANCE for Nurses archives:
Led by the LampThe Nightingale Initiative for Global Health has created the Nightingale Declaration, designed to bring health to the forefront of world consciousness.For Florence Dee Jones composes and performs a song about nursing's heroine.
Copyright ©2008 Merion Publications

Multi-Lead Medics 12 Lead ECG Interpetation Workshop

You will notice that on June 19th or 20th you are each scheduled for an 8 hour EKG class. This an interpretation class that will be from 7:30 until 4pm at Presque Isle Inn and Convention Center. Bob Page is the presenter and he is nationally known author on this topic. This should be an excellent presentation and I hope you all bring alot of information back to your practices.

I have placed one copy of the Seminar Workbook on each unit for you to peruse prior to the presentation if you wish but they will be passed out at each session, so don't feel like you have to copy it unless you really want to have a copy ahead of time.

Vilma and I sincerely hope that this is a beneficial conference for all of you.

Tracy

Chart Review/Performance Improvement

In the FYI section-please welcome Mark Morrow back to PCU, he will be providing his compassionate care on PCU days in the near future.

Congrats go to Susan Plissey for passing her RN boards-she is finishing up orientation with Nicole on PCU nights and will be on her own around the first of May.

Bunny Estabrook is the proud grandmother of the Little Miss PI runner up.

Welcome to Robert Garrett a new CNA on PCU-he joins us from AHC and has already proven to be "johnny on the spot" with a lift so far.

We are missing Blossom Cyr's can do attitude on PCU and we wish her the best with getting her new business venture off the ground and will still she her as a casual staff on weekends.

New travelers for both areas on nights are Amanda Dobson, Robert Pina and Bill Bourke have joined the force in time to cover vacations-welcome them and help them with things as they arise.

Heather Michaud will be returning to SCU in the next few weeks-be sure to give her an understanding smile as she rejoins the fold as a mother of 3!

Thank you to Louanne Langley for all the organizing she has done with what remains in paper-we all appreciate having the needed paper in the files when we reach for it.

Carrie Haas has been working hard at the SCU orientation materials and checkoff lists. I know I appreciate the time she has taken with this project as well as Judy Morrill for serving as our tireless typist:) We love you Judy!


And drumroll please...as promised here are the actual numbers for our Performance Improvement Measures for Chart Reviews the First Quarter.

SCU - overall 86%

PCU- overall 91%

SCU started the year with a bang-Each nurse completed 2 reviews each for 100% compliance, February we dropped to 83% and March was down again to 75%. I can't stress enough how we all impact these items.

PCU for January and February was 86% and improved to 100% for March-these numbers demonstrate that we are capable of achieving greatness; please strive to be the best by doing your part.


Of all of the measures we monitor the most telling is the Critical Lab Reporting. SCU was 89% for the 1st quarter (100-100-67%) And PCU was 84% (75-25-34%) This is a no argument area our expectation is 100%. We have to document each critical result that we obtain. The process is clear. Whichever department that has the result {be that radiology with a positive CT finding to the lab with a high BUN or nuclear with a positive stress test} is to call the unit with this result, the registered nurse will read back the results[RBV] to whomever is calling. Document the result in Ad Hoc in Powerchart in the Provider Notification form clicking the critical result reporting button, sign the form. Page the provider, who understands that criticals have a 1 hour time limit to be reported-this includes the lab running time so often we have 30 minutes to relay the information. When the provider returns the page open the Provider Notification form from the FORMS tab and by right clicking on it to modify it and document actions taken/MD response.

Please know that I fully appreciate the time it takes to get the job done and all your efforts are not ignored. However we still have a way to go to get where we have to be, so your attention to these items shows on reviews.

Next week employee surveys will commence and you will be asked to go to the designated area to complete one starting April 28th.

O.K. how is this working as a mode of communication? I need some feedback....
Until next time.....
Tracy

Chart Reviews and Coumadin dosing

A few of you have raised a question on the timing of coumadin dosing. I have checked and doubled checked to be certain and according to Dr. Tewksbury and Cheri Fitzpatrick in the lab we will NOT affect lab results if we administer Coumadin at 1600 instead of 2000. 1600 is the default time set in order sentences so it will eliminate the retiming issues that we have had since we went live with Powerchart. So although this will be a change for us to adminster coumadin on day shift instead of nights rest assured we will not disrupt the lab results and most patients usually dose at this time at home so it will be more continuitity of care for them.

Chart reviews~yes, RN's are still expected to complete 2 charts per month. Our most recent quarter results are still lacking. With our decrease in the number of RN's it really shows if only one of us is not completing their share.

I will post the actual numbers but it was staggering the effect that just one person not completing them has on our statisitics. Thank you to those of you that are completing them-keep up the good work!

Tracy