Please ensure you are utilizing the parameters per MD orders when administering pain medication.

Example: Patient stated pain score 6.

MD Order:

Percocet 1 Tab PO Q6H PRN for pain score 1-3

Percocet 2 Tabs PO Q6H for pain score 4-7

Pain score greater then 7, call MD for additional orders.

Pain Medication Administration:

Percocet 2 Tabs PO Q6H

Please comment with questions. 

Thank you for your dedication to patient care!

Please review attached education regarding Dilaudid Ordering and Pain Re-Assessment. The Goal is to ensure safe and appropriate ordering of Dilaudid IV by creating layers of safety across the entire medication process.

Please comment below with questions. 

Thank you for your dedication to patient safety!

Dilaudid Dose Assesment

Please review education provided by our partners at Clear Lake Regional in the Gulf Coast Division.

Nimodipine is considered a critical medication and must be administered within 30 minutes of the scheduled administration time. If unable to administer within this time frame, please document a reason for delay or early administration in the comments section of the eMAR or in a nurse's note.

In an effort to assist with communication from Regulatory Body visits, our partners at Medical City Dallas have created a document: Regulatory Terminology vs. "Our Terminology." This document reviews potential questions and the answers as it relates to the common terminology.

Please comment with questions.

Thank you for all you do!

Regulatory Terminology

Please review the attached Bedside Shift Report validation form and ensure you are including all components into your Bedside Shift Report. I have also included a video that shows patient involvement and sharing personal connections during the Bedside Shift Report.

Bedside Shift Validation Checklist

https://youtu.be/rOJ2QdPHzvU

Thank you for dedication to patient care!

Comment below with questions.

The HCA Nursing Insights Falls Initiative has been developed to measure key process indicators(KPI's) demonstrated through evidence to reduce the frequency of patient falls.

The attached Fall Reference document includes Fall Logic, Key Process Indicators, Falls Outcome Measures,  and Upcoming KPI's.

Fall Risk Assessments should be completed for all patients upon:

• Admission
• Transfer Into a Location
• Shift Change

Please review the document and comment with questions.

Thank you for your dedication to patient safety!

Fall Reference Guide

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.

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!

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!