Enhancement: HCA is dedicated to fostering a culture that supports a patient’s right to be free from restraint. Restraint use will be limited to clinically justified situations, and the least restrictive restraint will be used with the goal of reducing, and ultimately eliminating, the use of restraints or seclusion. Identifying areas of opportunity for improvement through data is important to improve patient outcomes which aligns with delivery of safe patient care.

The following KPI's (Key Process Indicators) will be available to facilities.

Please review to ensure accurate patient care documentation.

KPI: Documentation of Second Tier Review

• A Second Tier Review is required after every Restraint Start Application. A Second Tier Review is not required for Restraint Renewals. Applies to all age groups, locations, and restraint types.
• A Second Tier Review is performed after every Restraint Start Application.
• All 9 questions on the Second Tier Review screen must be answered (not null)

KPI: Timeliness of 2 Hour Nursing Assessments

• A RN Assessment is required every two hours after the start application of a restraint until the restraints are removed. Applies to all age groups, locations, and restraint types.
• The time frame for the two hour check is dependent on the start application timestamp or the timestamp of the last RN Assess documentation.
• If any of the required 2 Hour RN Assessment questions are answered with “No”, the record needs to be flagged as needing review. Except for the following three questions: “Meets criteria for release”, “Response to restraint”, and “Level of consciousness”.

KPI: Patients Restrained

• This metric will be measured at the enterprise, division, market, facility, and department levels.
• Calculation All patients restrained (the distinct count of patients derived from the "Restraints Documentation" screen) divided by total patients (ADT-Admission, discharge, transfers) Exclusions Behavioral health restraints

CHG Bathing – EPIC Data As of Wednesday July 3rd facilities that are on the EPIC EMR will now be able to track their CHG Bathing compliance.

Please comment with questions or concerns.

Thank you for your dedication to Patient Care!

Hospital National Patient Safety Goal 15:

The hospital identifies safety risks inherent in its patient population.

NPSG.15.01.01

Identify patients at risk for suicide

Please review the attachments in regards to Suicide prevention in the Continental Division.

Suicide Prevention Policy: Division-wide, no longer facility specific

Patient Safety Attendant and Protective Observation Policy: Division-wide, no longer facility specific.

Suicide Prevention

Patient Safety Attendant

Thank you for dedication to patient care!

As reminder to all Mobile Heartbeat users, please make sure you are updating your unit and facility based on working assignment. This update can be done thru your dashboard. There is an educational course available in HealthStream Titled :Mobile Heartbeat MHCURE 19.1 Clinical User Tutorial - Test. The second module of this learning course reviews how to change the unit and facility. This course is available for self-enrollment at leisure.

Please comment below with questions or concerns.

Thank you for all you DO!

The importance of N95 mask fitting for those who perform direct patient care

1. What does N95 stand for?

N stands for non-oil based molecules. 95 stands for 95% of protection. N95 masks provide us 95% of protection against airborne transmitted diseases with non-oil based small particles. An example of such airborne transmitted diseases is Tuberculosis.

2. What about the other 5% of protections?

If we want to protect ourselves from airborne transmitted diseases, 95% of protection does not seem to be enough. Where does the other 5% come from? Properly putting on and removing the mask after each use, performing mask fitting at least once a year, and ALWAYS selecting the properly fitted mask to wear provide the remaining 5% of protection.

3. How often should you perform mask fitting?

The answer is AT LEAST once a year. Mask fitting should be performed again if there is any facial structure changes including significant amount of weight change. Educations information in regards to how to properly putting on and taking off the mask should be refreshed as well at each mask fitting session.

Please contact Lilly Ranney, BSN, RN at 954-514-1631 if you have any questions in regards to N95 mask fitting.

As a reminder please ensure you are scanning and documenting medication administrations in real-time to ensure we are protecting patient safety. A variance is created when a medication is back-timed, these variances are tracked by facilities.

Please comment with additional questions or concerns.

Have a wonderful weekend!

As a reminder to all, please review provided education on controlled substance practices. Please comment with any additional questions and/or concerns.

Thank you each for your dedication to patient care.

Controlled Substance Education

1. NEVER hand your sharps to anyone else.

2. NEVER let others hand their sharps to you including physicians.

3. ALWAYS engage safety device after an injection.

4. DO NOT use your hand to engage the safety device after an injection. ALWAYS use a surface that is away from you and the patient instead (e.g., instead of using your other hand to engage the safety, use the tabletop instead).

5. Place sharps into the sharp container IMMEDIATELY after an injection instead of leaving the sharp on the patient’s bed or the bedside table.

6. NEVER take your eyes off the sharp.

7. Make sure the sharp actually goes INSIDE of the sharp container.

8. NEVER attempt to recap a contaminated needle after an injection. Instead, toss the sharp into the sharp container immediately.

Dr. Jane Englebright, HCA Healthcare’s chief nurse executive, is among the list of nominees for Modern Healthcare’s 50 Most Influential Clinical Executives of 2019.

Voting is open and will close on May 10, 2019. Additionally, each e-mail address can register to vote one time, for one executive. Modern Healthcare’s 50 Most Influential Clinical Executives program honors clinicians working in the healthcare industry, deemed by their peers and an expert panel to be the most influential in terms of demonstrating leadership and impact. Previously known as Modern Healthcare’s 50 Most Influential Physicians Executives and Leaders.

Click here to learn more about the program.

Should you ever need to report an injury below are the steps to follow:

1.  Report the incident to immediate supervisor of the unit.

2. Complete incident report in Meditech (under "non-patient notification") with the assistance of supervisor/charge nurse if needed before the end of shift.

3.  Go to the ED of the facility for evaluation if needed.

4. Report the incident to HealthTrust Workforce Solutions.

5. Contact Employee Health Nurse: Lilly Ranney at 954-514-1631 for follow-up instructions and additional questions.

HCA injury reporting policies apply to HealthTrust WS employees, vendor partner employees should contact their employer.

Please comment below with questions or concerns.

Thank you for all you do!

Please review included education regarding restraint documentation:

Restraint orders must be renewed by the end of the calendar day (2359).This prevents restraining without an order while awaiting a new order.

Safety/Rights/Dignity status is documented with the other restraint component every 2 hours with the attestation that is was done 3 times per hour. Done now is used to document observation in real time and time stamps just one assessment complete.

Please comment with questions.

Have a great week!

Restraint Documentation