Update 6/3/2022
Greetings Team hope all is well ! Please read, nothing new just reminders.
1) Next staff meeting (2nd Tuesday of each month) – June 14th 0645 or 1845. We will have the Zoom option this time as well, I’ll email the link when I get it.
2) LWBS (left without being seen) AKA LWOT (Left without treatment) – we had a patient not be seen by a provider for an hour so they left, the next day they went to main and had some significant findings… that’s the “why” of our need to get every patient seen by a provider. The triage nurse has a lot of influence on “encouraging” throughput with the mid-level and providing creative ways for encounters. Getting patients back to rooms quickly and providing frequent updates will help as well…thank you for your efforts in this, we have improved significantly !
***I have to give corporate an explanation for every LWBS, the only way I will know why is reading the notes you leave in Cerner, please include efforts you made to get them seen, thanks!***
3) Techs and CNs work together at GS to utilize the double rooms; it is an expectation that we will utilize these rather than have 3’s in the lobby.
4) The Joint Commission is at another facility this week in Amarillo, we think they may be at NW in the next week or two. Please be diligent to keep up with all the EOC details.
a. One struggle we have is pain reassessment even if they say zero the first time, they will look for a reassessment. If they have any pain at all, even a 1, and no pain med is given they will want to see some comment about repositioning for pain, ice, distraction etc
b. No door stops, heaters, fans allowed
c. No sharps, meds, phi on WOWs…please get rid of the lidocaine 😊
d. Carts are to remain locked
e. Nails must be short and only paint is allowed
f. Please fill out engineering tickets for any water damaged or stained tiles.
g. It’s ok to ask for clarification on what an auditor is asking or to ask a peer for assistance
5) The master key at GS was lost, Danny brought us a new one. IF THE LIGHT ON THE BACK DOOR IS RED USE THIS KEY TO TURN ON THE ALARM…THE GREEN LIGHT SHOULD SHOW
6) AMBULANCE – Their cell phone is 806-316-1055
a. NW1 will call TSQ at 11a every day when they come on duty and check in to see if we have any transfers we haven’t called in, look at the TSQ and GS board
b. For example if you get a room # at 1040 and it’s non-emergent, it would be best to wait until we get the 11a call stating they are on duty to call this in to dispatch and utilize NW1. If it’s at GS we can tell the truck to head that way rather than arrive at TSQ.
c. Even if you say no to all the questions like “are they having difficulty breathing”, the patient will not just be a “transfer” but will require a priority truck based on a chief complaint like altered mental status, chest pain, etc. They will send the closest truck for this type of transport. Remember that while we wait on a room assignment, before we call dispatch, we can have the ambulance move to the other facility so that it will be the closest truck. Please let me know if you have any difficulties with this, call me or send me an email. ***Note, for true emergencies, we want the closest truck, I wouldn’t want any delays to move NW1!***
d. The hospital case manager(s) will on occasion be calling TSQ to check for NW1 availability for unfunded transfers. I printed out a log on 8.5 x 14 paper that is with the binders, a binder this size has been ordered. This log is not for all trucks but for keeping track of these. The TSQ CN should assist with calling these in to dispatch; the case manager should provide all needed information to make this simple. AMR has requested that we have one source calling in to use the truck. (GS will continue to call in theirs of course)
7) Kudos to Rhonda and Denise for working on the schedule – they are working diligently to balance meeting the needs of the unit while getting a schedule that will work well for you. Thank you for your understanding and flexibility during the piecing of this puzzle !
8) The CT construction is almost complete – the portable should be leaving 6/8. The good news is that we have a handle and a badge reader on that east door and can use it. Please be sure it gets closed appropriately for safety reasons.
9) Hand Hygiene Audits – we have to do 150 audits per month at each location. That sounds daunting but you could stand there and in a few minutes watch several people come in and out of rooms…each one is a “handwashing opportunity” and can be audited. There are forms for this at each site. I would expect us to have a 40-70% positive rate to be realistic.
10) REMINDER – I have to scan in the daily sheets and send them to corporate weekly. If you don’t know what I’m referring to ask someone to show you. There are many blank nights, ask day shift at shift change if you are unsure about what this is. In the same book is the monthly check of carts and supplies, this is to be completed by the 7th of the month. We label and pile up expired items to take them back to CS…the educators use these as needed.
11) Mandatory reporting – this can seem confusing or complicated. I won’t pretend to cover every situation but a review on some: Minors and geriatric (<18 or >64) are mandatory reporting to CPS or APS respectively for neglect, abuse, assault. For 18-64 yo adults – they get to determine if they want APD notified for assaults, sexual abuse, domestic violence, to include knife wounds. High velocity projectiles like gun shot wounds, even if self-inflicted, are always mandatory reportable. Animal bites are mandatory as well
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13) New nurse in the ED ? you may not know that the BON of Texas has special education requirements:
· Two contact hours related to forensic evidence collection for those who work in an emergency room setting
· Two contact hours related to older adults and geriatric populations for those who work with patients from these populations (such as in assisted living homes)
· Two contact hours of education related to nursing jurisprudence and nursing ethics before the end of every third two-year licensing period for all nurses
14) Both FEDs have new QR code cards, please be diligent to pass these out; we also have a lot of folders in the cabinets in both triage areas.
15) We have several new people! We are so happy to have them, welcome Lauren, Chris, Kerry, Katrina is back, Kim is back, Shay isn’t new of course but will be returning from maternity leave 😊.
16) Congrats to Marisela and her new baby boy!
I hope everyone gets a chance to travel or do some fun things this summer, we will work with you to help make this happen, thanks for all you do !
Andrea
