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Adult ED Staff Meeting. December 16, 2010. Quality Data -Jackie Ashburn. December 16, 2010. Antibiotic Stop Times. First IV antibiotic per patient. Documentation in Nursing assessment or Order Tracker Lost of $128.00 per medication/ Drips. Urine Contamination. Up is Good Goal is 85%

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adult ed staff meeting

Adult ED Staff Meeting

December 16, 2010

antibiotic stop times
Antibiotic Stop Times
  • First IV antibiotic per patient.
  • Documentation in Nursing assessment or Order Tracker
  • Lost of $128.00 per medication/ Drips.
urine contamination
Urine Contamination

Up is Good

Goal is 85%

Remember:

Give wipes

Instructions are key Never assume they know ( including men)

Instruct to collect mid stream.

Don’ts:

Use bedpans or urinals ( They are not sterile

Never use a sample that is greater than 30 minutes old

blood cultures
Blood Cultures

Sterile procedure

Can not draw from IV lines

Unless MD order to indentify line infection

Remember to scrub site and do not touch after.

Any difficulty document

edis elizabeth banks

EDIS-Elizabeth Banks

December 16, 2010

vph to inpatient transfer process
VPH to Inpatient Transfer Process
  • VPH patient to ED for treatment visit
    • Patient remains a VPH patient in Medipac (admission, discharge, transfer system)
    • This is for insurance purposes
  • If VPH patient admitted to VUH
    • Patient must be discharged from VPH
    • Readmitted to VUH in obs or inpatient status
    • New case number is generated for patient
    • Process in place to replay as many orders as possible
vph to inpatient transfer process1
VPH to Inpatient Transfer Process
  • Admitting Liaison starts process by notifying ED charge nurse with this page: “Bed name (MRN): Please notify Primary Nurse to play back order for VPH patient after Admitting Liaison completes the discharge process.”
  • Admitting Liaison will archive orders in HEO/WIZ.
  • Once process is completed, Admitting Liaison will notify Charge Nurse that HEO/WIZ orders can be played back
vph to inpatient transfer process2
VPH to Inpatient Transfer Process:
  • All documentation in Order Tracker should be completed prior to the transfer process
  • When patient is discharged from VPH, all orders that appear in Order Tracker for that VPH case number will no longer be present in Order Tracker
  • Orders can be viewed in StarPanel under ED Orders (this shows which orders completed, not completed)
vph to inpatient transfer process key features
VPH to Inpatient Transfer Process: Key Features
  • All archived orders that are re-played will come across to Order Tracker as new orders
  • One time Stat orders will not archive and playback because these orders are considered as past orders
  • If the One time order is not yet completed, re-enter order in HEO/WIZ so that you can document the order as “done” in Order Tracker
magnet dawn hawley

Magnet-Dawn Hawley

December 16, 2010

slide14

YOU ARE MAGNET• Evidence Based Practice• Team Support and Leadership• Encouragement and Education• Community Involvement• Commitment to Professionalism

slide15

ANCC – New Magnet VisionTo be the fount of knowledge andexpertise of nursing careglobally. Will be solidlygrounded in core magnetprinciples, flexible, andconstantly striving for discoveryand innovation. Lead thereformation of healthcare, thediscipline of nursing and care ofthe patient, family andcommunity.

slide18

5 Magnet Model Essential Elements1. Transformational Leadership2. Structural Empowerment3. Exemplary ProfessionalNursing Practice4. New Knowledge, Innovations& Improvements5. Empirical Quality Results

transformational leadership
Transformational Leadership
  • Identification of/understanding of nursing leader roles
  • Nursing Strategic and Quality Initiatives
  • How do you as a leader gain/use staff input for decisions & examples?
  • How do you as a leader value, encourage, recognize/reward & implement staff ideas (innovation)

* Key – Staff as Transformational Leaders

structural empowerment
Structural Empowerment

VUMC Nursing Shared Governance Model

structural empowerment1
Structural Empowerment

How does SG work in your area & EXAMPLES

  • Structures that support:
  • Professional Engagement
  • Professional Development
  • Community Involvement
  • Recognition of Nursing
slide22

The Vanderbilt Reputation• Ranked in Top 10 in 2009 US News &World Report in 3 Specialty Areas• Ranked in Top 25 in ALL Pediatric SpecialtyAreas (US News & World Report, 2009)• One of “Fortunes” Best Companies to WorkFor (Fortune, 2009)• Of 371 Magnet Status Organizations,Vanderbilt is one of only two in TN (ANCC,2010)

exemplary professional practice
Exemplary Professional Practice
  • How is the PPM implemented in your area?
    • Staff Satisfaction Data
  • How do you deliver care?
  • Staffing, Scheduling & Budgeting
  • Interdisciplinary Collaboration
exemplary professional practice continued
Exemplary Professional Practice-continued
  • Performance Evaluations/Peer Reviews/Goals
  • Ethics, Privacy & Confidentiality
  • Diversity & Workplace Advocacy
exemplary professional practice continued1
Exemplary Professional Practice-continued

Culture of Safety

(Proactive – Improve - Outcomes)

  • Staff and Patients
  • Nursing Sensitive Quality Indicators
    • Total falls vs falls with injuries
    • Pressure Ulcers
    • Restraints
    • All infections
    • Peds IV infiltrations
    • Handwashing
    • Medication Reconciliation
    • Others
exemplary professional practice continued2
Exemplary Professional Practice-continued

Quality Monitoring and Improvement

(Outcomes, Outcomes, Outcomes)

  • Patient Satisfaction
  • How nurses coordinate care
new knowledge innovations and improvements
New Knowledge, Innovations and Improvements
  • Research
  • Evidence-Based Practice
  • Innovation
slide29

Magnet ChampionsAdult Emergency Department:Hawley, Dawn Bransford, Bill Knipp, Kory Hamilton, Mary Brusch, Joan Vanderveldt, Gina Grubbs, Ali Brumley, Laren Sims, Matt Locklayer, Anthony Kossler, Rebecca Beckstead, Chris Wilson, Cathy

vanderbilt nurses are the elite in 2009 19 545 applications were received 1350 people were hired
Vanderbilt Nurses are the Elite• In 2009, 19,545applications werereceived.• 1350 people werehired.
prc marsha price

PRC-Marsha Price

December 16, 2010

slide34

14 - Now I would like to ask you some questions about the DOCTOR or DOCTORS who treated (you/your family member) in the emergency room. Overall, would you rate the quality of doctor care as:

slide36
27 - Would you say the likelihood of your recommending [+hospname+] to friends and relatives for emergency services is:
stroke update ali grubbs

Stroke Update-Ali Grubbs

December 16, 2010

iv tpa high alert medication
IV tPA: High Alert Medication
  • IV tPA is now a high-alert medication at VUMC which means that staff should follow safety strategies and defined procedures during all steps in the medication use process in order to minimize risk.
  • Being a High Alert medication means that IV tPA bears a heightened risk of causing significant patient harm when used in error.

**Review the Policy: High Alert and Look-Alike Sound-Alike Medications CL 30-06.26 https://mcapps.mc.vanderbilt.edu/E-Manual/Hpolicy.nsf/AllDocs/DA7AB99D84815A4C862577AF00747227

iv tpa high alert medication1
IV tPA: High Alert Medication
  • Administration of IV tPA as a high alert drug involves:
    • Primary nurse verifies drug indication corresponds to patient diagnosis and appropriate monitoring has been reviewed
    • Two licensed staff will verify the following prior to administration of IV tPA:
      • Drug and dose based on patient weight
      • Amount of waste
      • Amount of bolus to be administered over one minute
iv tpa high alert medication2
IV tPA: High Alert Medication
  • Amount of IV infusion via infusion pump to be administered over one hour
  • Primary nurse will verify waste amount withdrawn from vial followed by bolus dose withdrawn from vial followed by infusion dose administered via infusion pump
  • Primary nurse will document waste amount and name of second licensed staff member who witnessed waste, bolus dose amount and time administered and infusion dose amount and time initiated in EMR. 
requirements
Requirements
  • Must be off orientation and actively assigned to trauma (may be staff, charge nurse or paramedic)
  • Willing and able to participate in this process; answer email/inquiries promptly
  • Attend meetings set up by the group (on/off campus)
projects
Projects
  • Develop Room Checklist/Standards
  • Outline Orientation Contents
  • Standardize Practice within Bay
  • Outline Core Requisites to work in Bay
know the facts
Know the Facts
  • Domestic Violence is any pattern of behaviors that attempts to control an intimate partner or family member by the use of fear, manipulation, isolation, intimidation, physical, sexual, and/or verbal abuse.
  • Tennessee consistently remains in the top 10 states for domestic violence related homicides. Currently, we are number 5.
  • One in four women will experience some form of abuse in her life.
  • In America, every day three women are murdered by the man who says he loves her (American Bar Association Commission onDomestic Violence).
  • The sole purpose of domestic violence is power and control.
  • Typically, this control starts out slowly, and increases over time.
slide48
Weaver Domestic Violence Center
  • Weaver Center is the largest domestic violence shelter in Tennessee.
  • We provided 15,753 bednights of shelter last year to 233 women and 187 children fleeing domestic violence.
  • Staff answered 3,791 calls on our 24-hour crisis line.
slide49
How can you help?
  • Call the YWCA Crisis and Information line at 242.1199 or 1.800.334.4628.
  • The Crisis and Information Line is available for anyone whether they are in immediate crisis or seeking to offer assistance or support to someone who is in danger.
  • Call the YWCA crisis line to get support on how to talk to a friend or family member regarding safety planning.
slide50
Susan French

Director of Outreach Services

983.5150

Susan.french@ywcanashville.com

a few reminders marsha price
A Few Reminders – Marsha Price
  • If at all possible, please sign up for text paging
  • Triage nurses: please let the triage attending know if a patient elects to leave without being seen. Triage attending will communicate a plan and wait times to minimize our LWBS patients
  • There is a new policy with regard to the Labeling of All Lab Specimen. They all must be labeled with your VUNET ID.
meeting evaluation marsha
Meeting Evaluation – Marsha
  • 5 – Excellent
  • 4 – Very Good
  • 3 – Average
  • 2 – Below Average
  • 1 - Poor

Use the poll on our Team Member Only Website to Evaluate the Meeting. We will send you a link today.

Share any comments now.