With the Meditech enhancement being so extensive, attached are some additional educational references specific to Restraint Documentation and Discharge Workflow Changes. Please contact your Regional Director of Clinical Operations with questions.

Restraint

DC Flowsheet

Discharge Enhancement

Protect yourself and your patients by assessing for and administering the flu vaccine. Please review the attached document highlighting the assessment, documentation, and administration of the flu shot for your patients.

Flu Education

Friendly Reminder: Flu shot documentation is due to HealthTrust by 10/31.

One of the goals of the Controlled Substance Safety Component of the 2018 Clinical Safety Improvement Program is to decrease the potential for patient misuse of prescribed opioids post-discharge. To work toward meeting that goal patients need to be educated on safe use, storage, and disposal of opioids. Please reivew the updated Teach/Educate intervention below and contact your Regional Director of Clinical Operations for questions.

Teach/Educate Intervention: Opioids

Did you know.....The Clinical Excellence blog has links to Atlas and Lippincott. Please feel free to use these sites for additional education and reference to policy. The links can be found on the top of the page.

The Woman's Hospital of Texas announced  new infection control protocols for staff providing direct care in their neonatal intensive care units. The new measures are likely to impact all NICUs in the Gulf Coast Division so all HealthTrust NICU nurses working in, or traveling to the region should review the attached handout. The first 10 NICU nurses who comment with the name of the leading type of device assisted infections in the NICU will get a prize! HINT: The Answer is in handout!

 BARE BELOW THE ELBOWS

SPOT is an application that monitors all patient labs and vitals in real time and uses the information to identify patients who are risk for sepsis.

Early identificaton = Early treatment.

I have attached an educational reference on SPOT. This training is included in annual update this year. Please reach out to your Regional Director of Clinical Operations for additional questions

SPOT Handout

Many of you have heard about the process changes the EHR Release Program is undergoing with the largest change combining provider documentation, nursing documentation (EBCD) and provider ordering for Inpatient and ED into a single release per quarter. All updates can be viewed in atlas.

Evidence-Based Clinical Documentation (EBCD) Regular Maintenance updates plus documentation enhancements for Moderate Sedation, Restraints, Discharge Instructions, and Vaccines and Regulatory updates for Inpatient Rehab.

Meditech 5.6.7 OE Includes updates to Restraints and new OE screens for Discharge, Discharge with Parameters, and Pediatric Asthma Severity Scoring Tool

Meditech 5.6.7 Discharge Includes updates to Discharge Plan, PDoc and EBCD Discharge documentation. Also includes new OE screens for Discharge and Discharge with Parameters with workflows for both Providers and Nursing.

Meditech 5.6.7 Restraints Includes updates to Restraint documentation in OE and EBCD to align with the corporate policy.

EBCD 2018.3 Provider Discharge Process (003)

EBCD 2018.3 Nursing without DC Restraints

EBCD 2018.3 Restraints Update (End User Education) (002)

Education from Clear Lake Regional Hospital in the Gulf Coast Divison : When Nimodipine is ordered for a non-traumatic subarachnoid hemorrhage it is considered a “critical medication”. This means Nimodipine must be given within 30 minutes of the scheduled administration time. For instance, if Nimodipine was scheduled for 1300, the nurse must administer sometime between 1230 and 1330 or document an acceptable reason for inability to administer within the allotted timeframe (patient in a procedure, patient off the unit, patient hypotensive so the physician was notified prior to administration, etc…). The Standard Medication Administration Times policy discusses administration of Nimodipine as a critical medication and the need for it to be administered within 30 minutes of the scheduled administration time. Also, Nimodipine administration compliance is closely monitored during our annual Comprehensive Stroke Survey. The nurses are able to see the critical medication instructions if they click on “***** NOT FOR IV USE ******…” in the eMAR. Clear Lake Regional Hospital has had quite a few non-traumatic subarachnoid hemorrhage patients in the months of August and September and we noticed a few fall-outs on Nimodipine administration. I have attached the Standard Medication Administration Times policy and a snap shot of where to click in the eMAR to view the administration instructions.  Please contact your Regional Director of Clinical Operations for questions.

Nimodipine eMAR Order

Critical Medication Administration Policy - Nimodipine.

The West Florida Division Critical Care Service Line Council has created guidelines for documenting drips in EBCD as an action to improve care and decrease risk to patients. Please review the guidelines below and contact your Regional Director of Clinical Operations for additional quesitons or concerns.

Guidelines for documenting drips

MidAmerica has recently transitioned to the utilization of DeRoyal wrist restraints. There is a HealthStream video titled, "Overview of the DeRoyal wrist restraint-CESL", that can be taken should you require additional information and/or education. This is not required education and supplemental only. Please reach out to your Regional Director of Clinical Operations for questions or concerns.