All facilities in the EFD will be transitioning to using Plain Language to announce emergency codes/alerts – Medical, Security, & Facility.  We are converting to this format of announcing our codes to improve the safety and responsiveness of all within our facilities – our patients, visitors, and staff. We are not changing how the staff calls codes, what will change is how the operator announces codes. 

Please review the attached huddle card and ensure you are aware of the Emergency alert process for your facility. 

Emergency Codes

Thank you for your attention to PATIENT SAFETY!

Please review attached Bladder Management Program PowerPoint shared by our partners in the East Florida Division. 

The Goal of the program is to implement a systems-based appropriate indications for catheter placement and reduce overall indwelling urinary catheter utilization. The program supports current policies and promotes alternate choices to indwelling catheters. 

Please educate yourself on the program and the BMP algorithm. 

Bladder Management Program

Thank you for your attention to patient safety!

Our partners in East Florida have shared with HWS Guidelines for Agency and Float Nurses. Please make sure you are familiar with the guidelines at the facility in which you are staffing. 

• Ensure I-Mobile is signed in and out and number written on white board
• Document in Meditech per EBCD guidelines
• If caring for a patient on Telemetry obtain a rhythm strip, validate, sign, date, and place in chart per unit guidelines.
• Ensure you punch out for lunch
• Assess all high fall risk patients and ensure Fall Precautions are implemented if applicable
• Complete hourly Safety rounding
• CHG documentation must be documented under Hygiene Care Intervention
  • Conducted daily for lines and foleys
  • First documentation at time new line placed
• Ensure you are following policy and guidelines for C. Diff Orders
• Foley Catheters/Drains
  • Date Inserted on bag
  • Stat lock in place
  • Bag below bladder off floor
  • Red Seal intact
  • No loops or kinks
  • Green clip in use
  • Emptied 3/4 full and before transporting
  • Documentation Q shift: Start Date, Reason, Patient Education
• Central Lines
  • No blood draws from Central Lines
  • Appropriate Dressing in place
  • All edges intact, CHG centered
  • Dated, timed, initialed
  • Orange caps on all unused ports and IV tubing ports
  • Dressing change and tubing change per facility guidelines
  • Document Q shift
  • Utilization of Bio patch
• Ensure Proper documentation of wounds and completion of wound care orders
  
  

Thank you for all YOU DO!

Great changes are coming to the Meditech Nurse and Charge Nurse/Clinical Nurse Coordinator Print Report and Magic Key Menu in NUR and a new EDM Desktop Menu. Nurses and charge nurses will begin to see a different, simplified, look and feel to their menu.

Print Report Menu

The Print Report has been streamlined to make it easier for nurses to find the routines which are utilized most frequently throughout the shift. With the exception of the EBCD Reports, all other reports have been moved to the Magic Key Menu.  

NUR Magic Key Menu

The Magic Key Menu has been standardized across the entire East Florida Division to allow for a more consistent experience across all of our facilities. 

Integrated Desktop (Status Board Buttons)

The Integrated Desktop (Status Board Buttons) has also been standardized and nurses may notice that the sequence of the buttons may be have changed up or down on the list of options.

Variance Menu

A new button has been added to the Status Board options. The Variance button houses facility specific reports utilized for specific process workflows at each individual site.

EDM Desktop Menu

The EDM Desktop Menu has been restructured and unutilized routines removed thereby de-cluttering the desktop menu.

Menu

EDM

MIS

Inpt

Thank you for ALL YOU DO!

A File Time Variance is a discrepancy of 30+ minutes between the File Time and the Administration Time of a medication. A File Time Variance is created when the user scans the medication after the administration and edits the time to indicate the time the patient was given the medication. File Time Variance is a show of false documentation of medication administration and against policy.  

Please ensure medications are being scanned and documented in real time. 

Included is an educational document for review on File Time Variances. 

FTV

Thank you for your dedication to patient safety!

In an effort to prevent safety fallouts the North Texas Division, Medical City Fort Worth has created a handoff checklist. Please ensure you are familiar with the checklist and utilize the Hand Off "Time Out" to review the important safety elements. 

Hand Off "Time Out"

Thank you for all you Do!

Mobilab app- will now be available on the iMobile devices to utilize as well as still available on the desktop. 

The app will be pushed out to all the devices on 4/6/21 throughout the San Antonio Division.

The QR Code below is a video providing an overview and resource of the app:

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Please contact the charge nurse at the facility with additional questions. 

Thank you for your DEDICATION to patient care!

Please ensure IV Stop Times are documented in the ED. A yellow information box alert will display in eMAR to ensure proper documentation of the IV stop time. This is a required field if there are IV medications on the patient's eMAR in the ED.

ED: IV Stop Times

Thank you for all you DO!

Our partners in the Capital Division at CJW have shared some education regarding the current safety standards for PPE usage and Infection Prevention. 

REMINDERs:

Ensure we are following appropriate PPE measures at all times.

• Universal masking is still in full swing- please ensure you are masking up as you enter the facility each day and continue with the appropriate mask per your patient population throughout your shift.
• All direct patient care requires both a mask and face shield/goggles
• All non-COVID patient interactions require at least a mask, eye covering/face shield, and appropriate hand hygiene.
• Goggles are to be worn in all patient care areas, including the halls
• Safety Stand-Down

Please make sure you are adhering to the facilty specific PPE utilization and safety standards. 

Thank you for your dedication to Patient Care!

Our partners in the East Florida Division have identified some areas of opportunity for Education on Central Line and Foley Catheter Insertion and Maintenance.

Please review the identified gaps as well as the education for Central Line Dressing Change Policy, CLABSI, and CAUTI. 

Should you have any additional questions, please follow-up with the charge nurse on shift. 

FOLEY:

• Two-person insertion
• Insertion Date and Time on the bag
• Dependent Loops
• Indication Appropriateness
• Plan to address removal
• Placement of Foley Tubing
• Missing Securement Devices
• Reassessment
• Order placement in EHR
• Insertion, maintaining asepsis

CVC:

• Dialysis Biopatch (7mm needed)
• Date and Time when dressings are changed
• Weekly Dressing Changes
• Sutures (Too close to the skin)
• Gauze Dressing (Duration)
• Swab caps on all ports and line hubs
• Scrub the Hub (Duration)
• Non-Intact Dressing (reinforced with tape)
• Gauze wrap on Dialysis ports
• Plan to address removal
• Reassessment
  
  Central Line Policy
  CAUTI
  
  CLABSI
  
  

Thank you for your DEDICATION to PATIENT SAFTEY!