Our partners in the North Texas Division have implemented Pre-Rounding with each front line nurse prior to nurse leader patient rounds; with the end goal of improving patient clinical outcome and decreasing patient anxiety.

Pre-Rounding Consists of Three Questions:

1. Patient's preferred name

2. Personal connection

3. (In-Patient) How did the patient participate in Bedside Shift Report?

3. (Emergency Department) What is your patient waiting for in regards to tests and treatments?

Please make sure you are aware of the Pre-Rounding expectations and purpose.

Included for review and reference is an educational document on Pre-Rounding.

Thank you for your dedication to Patient Care!

Comment below with additional questions.

Please review attached Patient Handout regarding the new eSurvey/mail process. The handout will be included in admission and discharge education provided to the patients. Please ensure you are educating the patients of the importance of the survey and completion process.

Thank you for all you do in your dedication to patient care!

Comment below with additional questions.

Press Ganey Survey

Goal: To improve knowledge and responsiveness regarding SPOT alerts.

SPOT is a program that uses artificial intelligence to screen Meditech for Sepsis. It looks at : SIRS criteria (HR >90, RR>20, T: 38C/100.4F or < 36C/96.8F; WBC > 12,000 or <4,000) PLUS Suspicion or presence of an infection as evidenced by patient being on antibiotics or blood cultures being drawn in the past 48 hours.

Immediate Sepsis assessment and documentation determines SPOT Tier 0, Tier 1, Tier 2, or Tier 3 and the level of response necessary.

Process

SPOT alerts

Telemetry Technician notifies RN

RN assess patients and documents Sepsis Assessment in Meditech

Documentation to occur in less than 60 minutes from call or text.

This snoozes the patient from alarming for the next 6 hours.

Please review provided education reference from Los Robles in Far West Division.

Sepsis

Please ensure when working in the Gulf Coast Division Facilities the following Discharge Expectations are being met:

- 30 Minute Acknowledgement of Discharge Orders

-120 Minute Discharge Goal

Thank you for all your hard work and dedication to patient care!

Attached are care and documentation expectations for sitter patients provided by Medical City Plano located in the North Texas Division. Please ensure you understand the facility care and documentation expectations for the sitter role.

Please comment with questions.

Thank you for your dedication to patient safety!

Sitter

Sitter Documentation

As a reminder, please ensure daily weights are being assessed and documented on ICU/CCU patients. 

Please comment with additional questions.

Thank you for your dedication to Clinical Excellence!

The San Antonio Division utilizes the Cactus Smart Sink for Controlled Substance Waste Management. Included in this education review are key points and a document reviewing FAQ's.

Key Points: -

• Controlled substance SOLIDS only in the SOLID portion of the sink
• Controlled substance LIQUIDS only in LIQUIDS portion of the sink
• Controlled patches only in the PATCH slot of the sink
• NO SHARPS
• NO VIALS
• NO PAPER/TRASH
• Utilize fast fill ONLY if adding 250ml or more to the liquid side

Please comment with questions.

Cactus Smart Sink

Thank you and Have a great day!

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!