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Evaluate routinely, based on kind of restraint IE if it’s a violent restraint, q15 min at minimum Assess skin q30min, remove q2hr and provide ROM,

Great reference for this:  Common Breaks in Sterile Techniques, published by the AORN Journal Common breaks Not noticing compromised packaging Not noticing moisture on or

Hand washing compliance is being met Trash is disposed of properly Staff is consistently wearing appropriate PPE

Definition Sterile gloves, mask, and other necessary sterile supplies Maintain sterile technique Follow appropriate protocol if sterile field is broken

Varies depending upon facility.  Can include: No fresh flowers or fruits Ill visitors are not permitted Many people institute or order “reverse isolation” however, per

For example; if a patient is on contact isolation, we must educate the patient and family about the use of gowns, gloves, and hand washing,

Inform appropriate personnel Infection Control department Center for Disease Control Summary of Notifiable Infectious Diseases, CDC (last updated 2014)

Whenever you’re providing care, ensure you’re keeping everything clean (or sterile, if required) Examples of situations… When you remove the cap from the spike on

Apply principles of triage and evacuation procedures/protocols Check out Episode 059 for triage principles Know how to evacuate patients Horizontally before vertically Know what to

Acknowledge and document practice error per policy For example, medication error, accidental needlestick, incorrect order entry, patient transferred to incorrect unit Evaluate response to error/event/occurrence

Examples include lighting, handrails, kitchen safety Apply knowledge of patient pathophysiology to home safety interventions Are they hard of hearing, have visual deficits? Do they

Follow procedures for handling biohazardous materials Ensure proper labeling is in place For example, linen used with a patient with chemotherapy Demonstrate safe handling techniques

Carpal tunnel, back injuries are common examples Encourage appropriate body mechanics and not merely treating pain when it occurs Proper posture is essential Encourage working

Nurses frequently use a color-coding system to triage patients, as identified by the facility Example: Red: highest priority, life-threatening yet survivable injuries Yellow: medium priority,

Important that only the sickest ones are in the facility Think patients on ventilators or respiratory support, on vasoactive medications, patients that would likely die

Do not blindly follow orders; practice with a questioning attitude Quote from Scrubs, the TV show Nurse (to doctor): “Doug wanted me to give him

You must check their appropriate ID before doing anything Medications: check name, birthday, and so forth Check patient’s armband (or other identifying device) if patient

Change positions Pillow support Active and passive range of motion Routine stretching of the shoulders, neck, arms, hands, fingers

Participate in performance improvement/quality improvement process Utilize research and other references for performance improvement actions Report identified patient care issues and problems (utilize chain of

Examples of necessary referrals include therapy services (physical, occupational, speech), wound care, nutritional services, and so forth Recognize the need for referrals and obtain necessary

Important to ask about all allergies, not just medication allergies Some medications may have ingredients from different foods in their coating or capsules Must ask

Many facilities have various protocols on how to deal with various safety issues Falls Armed intruder Large patient influx/at capacity Infant abduction Weather issues Acts

Various factors can influence the likelihood that a  patient will get injured Age and developmental stage: elderly as well patients that may physically be older,

Visual: can they see what’s in front of them while walking? Can they see that they are taking the appropriate medication? Hearing: can they hear

(This does not include medications) At home oxygen and supplies, CPAP’s, assistive devices, drains, tubes, and so forth. Make sure assistive devices are sized appropriately

Call lights Adaptive call lights can be used for patients with poor dexterity Phones, or other technology

Know your state board of nursing Do not attempt to provide care outside of this scope – it is illegal Example: Texas Board of Nursing

Two codes of ethics for nurses Last updated 2015 First developed in 1953 Last updated 2012 The American Nurses Association Code of Ethics The Code

Issues arise frequently that require the nurse to address them and ensure the problem has been resolved Examples Lab problems: unable to get serum sample,

Report will look different in various areas of the hospital ED report is very short and concise Critical care report is very detailed Floor report

Keep your password of EHR’s protected and confidential Don’t talk about sensitive information in public areas Speak with patient about which members of their support

Make sure the patient knows that their privacy is a priority to us It is one of their rights, it is not optional Intervene if

The nurse is at the bedside with the patient 24 hours/day and they typically feel most comfortable with their nursing staff.  Therefore, if a problem

Nursing staff Continual care provider, advocate, administer medications and orders placed by medical team, evaluate effectiveness, notify medical staff of concerns, facilitate collaboration of entire

Discuss treatment options with the health care team and make sure you understand them fully, then the physician (or support staff) will present to the

The patient and their support system must have all information related to the discharge process as early on as possible Location, contact information (and contact

Become familiar with your community’s resources that can be helpful to patients attempting to maintain independence Nursing homes, respite care, SNF, home health agencies, Meals

NCSBN Delegation | ANA: Developing Delegation Skills You will be responsible for delegating tasks to others; nursing assistants, other nurses, and so forth Not all

Welcome to our brand new . . . hot off the presses podcast.  This podcast is designed to provide you with a step-by-step outline for

Advocating – help the patient and their support system understand the clinical picture and identified treatment options, identify their wants/needs, support the patient, speak on