Updates 1/26/2022
Not that it’s over, but our numbers have backed off a bit so we need to work on a few metrics that were difficult during the storm. Thank you all for staying in the boat! It has been mentally and physically exhausting; I hope that the nice staffing levels and bit lower census will give you all the break that you need and deserve.
1) Staff Meetings: starting Feb 8 we will have staff meetings the 2nd Tuesday of every month at 0645 and 1845. We will try this in the TSQ west lobby by closing it down before we start. 50% attendance will be the expectation.
2) Chart audits will begin again at the end of January – PLEASE INCLUDE A PAIN ASSESSMENT IN EVERY DISCHARGE VS SET. As we continue to fill positions to staff with 2 techs per shift, this would be a great job for them to do on all discharge patients.
3) When there is a chart made in error like two for the same person, make sure to not discharge them as an LWOT or Left before MSE complete and if registration has to assist make sure they know it is not an LWOT but a REGE. This is skewing our LWOT numbers.
1) Did you sign up for the FED party ???? https://nwthsfed.com/bowling-bash Thurs, Feb 17, 7p-10p: 7p-9p bowling and a 1 hour game card that can be used during bowling or after
2) Melissa and I sent out an EKG email, read it in full, the highlights: always enter patient identifiers before “muse and print” or transmitting, Dr needs to put time they saw it on EKG, we will soon be starting to scan our EKGs, AMAs, and other important forms…more to come.
3) AMA – there should be a form on every AMA chart, even if they do not stay to sign. Important elements: state that you gave risks/benefits or that you tried but they wouldn’t stay, that you attempted to get the Dr to talk to them but they wouldn’t stay, IF THE PATIENT DOESN’T SIGN THE AMA HAVE TWO NURSES OR THE NURSE AND A PROVIDER SIGN
This is specimen / lab scanning: All labs should be collected at the bedside before the samples leave the room; the patient wristband shall be scanned and then the lab label scanned as well. Please be diligent in this practice. I know there have been issues with label printers, scanners, and computers. If these are not functioning properly at this point, enter a repair ticket and let me know as this process is an expectation we need to return to for patient safety. Below is last year’s data for GS and TSQ, you can see when our volume exploded that we had an obvious drop off in specimen scanning.
GS 2021 scanning
TSQ 2021 scanning
1) Medication scanning: Below are our rates from 2021. Below that is an explanation of what to do when there are two stickers, not sure this is an issue for us. Place a midas or send us an email about meds that you can’t get to scan.
1) This is last month…just to give you an idea of where we were last month and where we need to move towards. Remember, I was here and know the issues, many of which we had no control over !
AVG discharge LOS should be < 90 min
LWBS (left without being seen by a provider, AKA LWOT left without treatment) <0.25%
AMA rate <1% (woohoo, we did that)
My main concern is with the LWBS / LWOTS – I have asked the charge nurses to let me know details about each one of these. Also, please help by putting in a note about the reason. Make every effort to inform physicians when you feel a patient is a risk for leaving and make them as comfortable as possible.
1) Attached is information on EMTALA and EDs that corporate sent out, it’s a good read.
2) NEW STAFF ! Welcome travelers Stephanie, Tiffany Gravador-Flores, Diana arrives 1/27 and new NW to the FEDs Jayla, Rebekah, Michaela (starts 1/31), Brooke, Rick, Drew, Kasondra
