Disclosure Statement

Size: px
Start display at page:

Download "Disclosure Statement"

Transcription

1 Rectal Hydration and Medication Administration: Cost effective Strategies Robert Parker, DNP, RN, CENP, CHPN, CHP Chief Compliance Officer, VP of Clinical Excellence and Integrity Intrepid USA Disclosure Statement No conflict of interest exists for any individual in a position to control the content of this educational activity 1

2 Desired Learning Outcomes At the conclusion, participants will be able to: Incorporate new ideas that can help improve patient outcomes Incorporate new understanding that can drive nursing efficiency Leverage existing resources to reduce costs 2

3 Study Aim Palliative program QI project to look at the feasibility of using a rectal administration catheter to facilitate safe, easy, comfortable and effective hydration and medication delivery via the rectal route, and the ability to treat changes in patient s condition while decreasing the need for parenteral therapy and ED/hospital utilization including general inpatient level of care. Parenteral Dosing Definitions Injection or infusion (IV, SQ, IM) Hypodermoclysis Administration of fluids subcutaneous Proctoclysis Administration of fluids via the rectum 3

4 Cost Challenges Increased utilization of general inpatient Delays causing ED/hospital utilization Supplies Parenteral dosages are costly Staff time Contract services Safety Challenges Patient Insertion of an IV can be difficult or contraindicated Pain Infection Infiltration Combative patients Nursing Proper skills training to insert an IV Difficult venous access patients Needle stick Other injury 4

5 Anatomy and Physiology of Microenema delivered Medication Mucosa is highly vascularized High % absorptive cells Liquid medications absorbed more quickly than suppositories Rapidly enters the circulation Anatomy and Physiology Proctoclysis Descending colon primary function to reabsorb fluids Fluid absorbed by diffusion into bloodstream Fluids should be hypotonic H20, Pedialyte Fluid flow of 250 ml/hr. tolerated well Based on literature Recommend break of 2+ hours between 250ml infusions Recommend volumes around 1000ml 1500ml/24hr 5

6 Versatile Route of Delivery Medication Versatility Rectal SQ IV SL Opioids NSAIDS Limited Benzodiazepines Limited Antiemetics Anticonvulsants Sedatives Antidepressants Neuroleptics Anticholinergics Steroids Antibiotics Study Results Ten of 10 (100%) participants from SNF, and 10 of 10 (100%) participants from hospice completed the study with 23 total use cases Hydration was effective in all 23 use cases, with all participants tolerating the intervention without signs of discomfort or expulsion of fluids The APN and attending physician who performed the prospective chart reviews deemed the patient s change in condition serious enough in 17 of the 23 use cases to warrant ED/hospital utilization or general inpatient level of care had the intervention not been successfully performed 6

7 Sample Study Order Sets Study Results Of the 17 use cases deemed serious enough to warrant ED/hospital utilization, 15 (88%) avoided a transfer to an acute setting after successful intervention with the catheter Each of these patients* returned to their previous oral medication and hydration regimen For the two patients transferred to the hospital it was necessary for acute care services mandating a transfer and not the failure of the intervention 7

8 Hospitalizations 66yr old male admitted to the SNF for ESRD and cardiac conditions after recent hospitalization. He was admitted to our community based palliative care program at the same time. Several days later, patient became hypotensive, and lethargic. The palliative APN gave orders to initiate the rectal catheter, and obtain a portable EKG. The EKG reading showed he was in Afib and he was sent to the ED and subsequently admitted to the hospital. Hospitalizations 44yr old male admitted to the SNF for acute kidney failure after recent hospitalization, he was also admitted to our community based palliative care program at the same time. Patient developed severe N/V and quickly became dehydrated. The palliative APN gave orders to initiate the rectal catheter. Symptoms resolved within 1 hour; however the patient s family requested that he be sent to the ED. Patient was not admitted to the hospital, and was quickly returned to SNF without further treatment. 8

9 Study Findings The catheter provided a safe, easy, comfortable and effective alternative to parenteral delivery options The intervention appeared to provide an effective and efficient way to treat patient s changes in condition leading to improved quality metrics and reduced ED/hospital utilization and use of general inpatient level of care Satisfaction Patient satisfaction with comfort and ease of use was high 12 patients who were able to verbally respond, reported comfort as 5 The remaining patients, the nurses performing the procedure reported the patients tolerated the intervention with no signs of discomfort All staff reported a 5 for both ease of use and perceived patient comfort 9

10 Analysis The intervention allowed us to quickly respond to patient s changes in condition when oral route failed Eliminated the need for IV infusions Catheter was initiated within 5 min. of order in SNF Patient s symptoms resolved within min. from initiation High satisfaction with patients and families 10

11 Questions? Robert Parker, DNP, RN, CENP, CHPN, CHP Chief Compliance Officer, VP of Clinical Excellence and Integrity Intrepid USA References Lyons N, Nejak D, Lomotan N, et al. An alternative for rapid administration of medication and fluids in the emergency setting using a novel device. Am J Emerg Med 2015;33:1113.e e6 Honasoge A, Parker B, Wesselhoff K, Lyons N, Kulstad E. First use of a new device for administration of buspirone and acetaminophen to suppress shivering during therapeutic hypothermia. Ther Hypother Temp Manag. 2016;6(1):48 51 Dychter S, Gold D, Carson D, Haller M. Intravenous Therapy: A Review of Complications and Economic Considerations of Peripheral Access. J Infus Nurs 2012;35:84 91 B Bruera E, Pruvost M, Schoeller T, et al. Proctoclysis for Hydration of Terminally Ill Cancer Patients. J Pain Symptom Manage 1998;15: Paez K, Gregg M, Massion C, Macy B. Promoting Excellence in Symptom Management Case Series: Case Study: A New Intervention for Rapid End of Life Symptom Control in the Home Setting. J Hos Palliat Nurs 2016;18:

Improving Care and Decreasing Costs

Improving Care and Decreasing Costs Improving Care and Decreasing Costs Utilizing the Macy Catheter for End of Life Symptom Management Natalie Latuga, PharmD, BCPS, Clinical Pharmacy Advisor Mary Gordon RN, IPU Director Paula Farwell RN,

More information

201 KAR 20:490. Licensed practical nurse intravenous therapy scope of practice.

201 KAR 20:490. Licensed practical nurse intravenous therapy scope of practice. 201 KAR 20:490. Licensed practical nurse intravenous therapy scope of practice. RELATES TO: KRS 314.011(10)(a), (c) STATUTORY AUTHORITY: KRS 314.011(10)(c), 314.131(1), 314.011(10)(c) NECESSITY, FUNCTION,

More information

E: Nursing Practice. Alberta Licensed Practical Nurses Competency Profile 51

E: Nursing Practice. Alberta Licensed Practical Nurses Competency Profile 51 E: Nursing Practice Alberta Licensed Practical Nurses Competency Profile 51 Competency: E-1 Critical Thinking E-1-1 E-1-2 E-1-3 Demonstrate knowledge and ability to apply critical thinking concepts throughout

More information

ADOPTED REGULATION OF THE STATE BOARD OF NURSING. LCB File No. R Effective April 4, 2016

ADOPTED REGULATION OF THE STATE BOARD OF NURSING. LCB File No. R Effective April 4, 2016 ADOPTED REGULATION OF THE STATE BOARD OF NURSING LCB File No. R091-15 Effective April 4, 2016 EXPLANATION Matter in italics is new; matter in brackets [omitted material] is material to be omitted. AUTHORITY:

More information

Transitioning OPAT (Outpatient Antibiotic Therapy) patients from the Acute Care Setting to the Ambulatory Setting

Transitioning OPAT (Outpatient Antibiotic Therapy) patients from the Acute Care Setting to the Ambulatory Setting Transitioning OPAT (Outpatient Antibiotic Therapy) patients from the Acute Care Setting to the Ambulatory Setting American College of Medical Practice Executives Case Study Submitted by Chantay Lucas,

More information

Home Infusion Therapy Corporate Medical Policy

Home Infusion Therapy Corporate Medical Policy File name: Home Infusion Therapy File Code: UM.DME.15 Origination: 10/04 Last Review: 03/2018 Next Review: 03/2019 Effective Date: 08/01/2018 Home Infusion Therapy Corporate Medical Policy Description/Summary

More information

If viewing a printed copy of this policy, please note it could be expired. Got to to view current policies.

If viewing a printed copy of this policy, please note it could be expired. Got to  to view current policies. If viewing a printed copy of this policy, please note it could be expired. Got to www.fairview.org/fhipolicies to view current policies. Department Policy Entity: Fairview Pharmacy Services Department:

More information

Adopting Standardized Definitions The Future of Data Collection and Benchmarking in Alternate Site Infusion Must Start Now!

Adopting Standardized Definitions The Future of Data Collection and Benchmarking in Alternate Site Infusion Must Start Now! Adopting Standardized Definitions The Future of Data Collection and Benchmarking in Alternate Site Infusion Must Start Now! Connie Sullivan, RPh Infusion Director, Heartland IV Care Lyons, CO CE Credit

More information

APHERESIS UNIT ORIENTATION

APHERESIS UNIT ORIENTATION INTRODUCTION What is Apheresis? Apheresis is a procedure by which fluid or cellular components are separated from the circulating blood either for the preparation of transfusion products (donor apheresis)

More information

Registered Nurse Intravenous Therapy and Peripheral Cannulation Competency Framework

Registered Nurse Intravenous Therapy and Peripheral Cannulation Competency Framework Registered Nurse Intravenous Therapy and Peripheral Cannulation Competency Framework Name: Location: Date commenced: Contents Competency: Page No: Page 1. Core: Introduction Demonstrate knowledge that

More information

Hospital Acquired Conditions. Tracy Blair MSN, RN

Hospital Acquired Conditions. Tracy Blair MSN, RN Hospital Acquired Conditions Tracy Blair MSN, RN A hospitalacquired infection (HAI), also known as a nosocomial infection, is an infection that is acquired in a hospital or other health care facility Hospital

More information

Hospice Care for the Person with Cancer

Hospice Care for the Person with Cancer Hospice Care for the Person with Cancer Hospice is a special type of care designed to provide comfort, support and dignity to patients with a lifelimiting or terminal illness. For hospice purposes, a life-limiting

More information

Maryland MOLST. Guide for Patients. Maryland MOLST Training Task Force

Maryland MOLST. Guide for Patients. Maryland MOLST Training Task Force Maryland MOLST Guide for Patients Maryland MOLST Training Task Force May 2012 Health Care Decision Making: Goals and Treatment Options Explanatory Guide for Patients Contents Introduction Section I Section

More information

Delegation for the Newly Licensed Practical Nurse

Delegation for the Newly Licensed Practical Nurse State of Nebraska Transition Grant Delegation for the Newly Licensed Practical Nurse Education Module Copyright 2011 Title: Delegation Learning Objectives: Upon completion of this education module, the

More information

Care of Patients Receiving Analgesia by Catheter Techniques Position Statement and Policy Considerations

Care of Patients Receiving Analgesia by Catheter Techniques Position Statement and Policy Considerations Care of Patients Receiving Analgesia by Catheter Techniques Position Statement and Policy Considerations Position Statement Registered nurses (RNs) are valuable members of the patient care team who are

More information

MEDICATION ADMINISTRATION: BELOW THE DRIP CHAMBER

MEDICATION ADMINISTRATION: BELOW THE DRIP CHAMBER KINGSTON GENERAL HOSPITAL MEDICATION ADMINISTRATION: BELOW THE DRIP CHAMBER LEARNING GUIDE FOR REGISTERED NURSES AND REGISTERED PRACTICAL NURSES Prepared by: Nursing Education Date: 2001 November Revised:

More information

*Your Name *Nursing Facility. radiation therapy. SECTION 2: Acute Change in Condition and Factors that Contributed to the Transfer

*Your Name *Nursing Facility. radiation therapy. SECTION 2: Acute Change in Condition and Factors that Contributed to the Transfer Gaining information about resident transfers is an important goal of the OPTIMISTC project. CMS also requires us to report these data. This form is where data relating to long stay transfers are to be

More information

MARSHALLTOWN MEDICAL & SURGICAL CENTER Marshalltown, Iowa

MARSHALLTOWN MEDICAL & SURGICAL CENTER Marshalltown, Iowa MARSHALLTOWN MEDICAL & SURGICAL CENTER Marshalltown, Iowa CARE OF PATIENT POLICY & PROCEDURES Policy Number: 4.37 Subject: Implanted Venous Access Device (Infus-A-Port), Nursing Management Of (Indwelling

More information

Simulation Design Template. Location for Reflection:

Simulation Design Template. Location for Reflection: Simulation Design Template Date: Discipline: Expected Simulation Run Time: Location: Admission Date: Today s Date: Brief Description of Client Name: Gender: Age: Race: File Name: Student Level: Guided

More information

Patient Self Administration of Intravenous (IV) Antibiotics at Home

Patient Self Administration of Intravenous (IV) Antibiotics at Home Trust Policy Document Ref. No: PP(16)319 Patient Self Administration of Intravenous (IV) Antibiotics at Home For use in: For use by: For use for: Document owner: Status: Clinical Areas Clinical Staff Patient

More information

New research: Change peripheral intravenous catheters only as clinically

New research: Change peripheral intravenous catheters only as clinically Content page New research: Change peripheral intravenous catheters only as clinically indicated, not routinely. The results of a nurse led and nationally funded multicentre, randomised equivalence trial

More information

ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610 X 6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS

ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610 X 6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610 X 6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS 610 X 6.01 610 X 6.02 610 X 6.03 610 X 6.04 610 X 6.05 610 X 6.06 610 X 6.07 610 X 6.08 610

More information

COURSE SYLLABUS RNSG 1301: Pharmacology

COURSE SYLLABUS RNSG 1301: Pharmacology COURSE SYLLABUS RNSG 1301: Pharmacology RNSG 1301 Introduction in the science of pharmacology with emphasis on the actions, interactions, adverse effects, and nursing implications of each drug classification.

More information

CONSENT FOR SURGERY OR SPECIAL PROCEDURES

CONSENT FOR SURGERY OR SPECIAL PROCEDURES Admission Date THE VALLEY HOSPITAL CONSENT FOR SURGERY OR SPECIAL PROCEDURES - Colonoscopy 1. Authorization. I hereby authorize Dr. (" my Doctor") and any such assistants or designees as may be selected

More information

Fundamentals of IV Micronutrient Therapy And Clinical Applications of Parenteral Products Seminar

Fundamentals of IV Micronutrient Therapy And Clinical Applications of Parenteral Products Seminar Fundamentals of IV Micronutrient Therapy And Clinical Applications of Parenteral Products Seminar Presented by: Intravenous Nutritional Therapy for Physicians and McGuff Company What: Fundamentals of IV

More information

U: Medication Administration

U: Medication Administration U: Medication Administration Alberta Licensed Practical Nurses Competency Profile 199 Competency: U-1 Pharmacology and Principles of Administration of Medications U-1-1 U-1-2 U-1-3 U-1-4 Demonstrate knowledge

More information

ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610 X 6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS

ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610 X 6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS Nursing Chapter 610 X 6 ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610 X 6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS 610 X 6.01 610 X 6.02 610 X 6.03 610 X 6.04 610 X 6.05 610 X 6.06 610

More information

STANDARDIZED PROCEDURE REMOVAL OF EXTERNAL VENTRICULAR DRAINAGE CATHETER OR INTRACRANIAL PRESSURE DEVICE (Adult, Peds)

STANDARDIZED PROCEDURE REMOVAL OF EXTERNAL VENTRICULAR DRAINAGE CATHETER OR INTRACRANIAL PRESSURE DEVICE (Adult, Peds) I. Definition This procedure will take place when a neurosurgery physician deems appropriate. The purpose of this standardized procedure is to allow the Advanced Health Practitioner to safely remove an

More information

ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610-X-6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS

ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610-X-6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610-X-6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS 610-X-6-.01 610-X-6-.02 610-X-6-.03 610-X-6-.04 610-X-6-.05 610-X-6-.06 610-X-6-.07 610-X-6-.08

More information

LESSON THREE. Administering oral, topical and inhaled medications

LESSON THREE. Administering oral, topical and inhaled medications LESSON THREE Administering oral, topical and inhaled medications Introduction The most common route of medication administration is oral, although perhaps an easier one to prepare it still warrants careful

More information

WYOMING STATE BOARD OF NURSING ADVISORY OPINION INTRAVENOUS THERAPY BY LICENSED PRACTICAL NURSES

WYOMING STATE BOARD OF NURSING ADVISORY OPINION INTRAVENOUS THERAPY BY LICENSED PRACTICAL NURSES WYOMING STATE BOARD OF NURSING ADVISORY OPINION INTRAVENOUS THERAPY BY LICENSED PRACTICAL NURSES Advisory Opinion Number: 03-123 Board Meeting Date: April 28-May 1, 2003 January 7-10, 2008 February 18,

More information

PICCs. Vascular access is the cornerstone in the. It s all about. Vascular safety:

PICCs. Vascular access is the cornerstone in the. It s all about. Vascular safety: Vascular safety: It s all about PICCs Optimal catheter and vein selection prove vital to patient safety initiatives. By Nancy Moureau, CRNI, BSN Practice challenges Special Vascular access is the cornerstone

More information

You and your Totally Implanted Vascular Access Device (TIVAD) - Portacath

You and your Totally Implanted Vascular Access Device (TIVAD) - Portacath You and your Totally Implanted Vascular Access Device (TIVAD) - Portacath Nursing A guide for patients and carers Contents What is a TIVAD?... 1 Why is a TIVAD necessary?... 2 How a TIVAD is inserted...

More information

PN Pharmacology and Intravenous (IV) Therapy Skills

PN Pharmacology and Intravenous (IV) Therapy Skills TRI COUNTY TECHNOLOGY CENTER Bartlesville, Oklahoma COURSE SYLLABUS for PN 1407 Pharmacology and Intravenous (IV) Therapy Skills Pharmacology and Intravenous Therapy Skills Course Title: PN 1407-- Pharmacology

More information

TEAMBUILDING CREATING A POSITIVE CULTURE IN HOSPICE CARE

TEAMBUILDING CREATING A POSITIVE CULTURE IN HOSPICE CARE ...from the Middle Ages to the 21st Century TEAMBUILDING CREATING A POSITIVE CULTURE IN HOSPICE CARE Emily Bradford RN CHPN Director of Hospice Services VNA Middle Ages: 16th-18th Centuries: Religious

More information

Meeting the NEW RCN Standards for Infusion Therapy in practice

Meeting the NEW RCN Standards for Infusion Therapy in practice Meeting the NEW RCN Standards for Infusion Therapy in practice sumanshrestha@nhs.net Suman Shrestha MSc BSc RN Advanced Nurse Practitioner Intensive Care Frimley Park Hospital suman_sr FRIMLEY PARK HOSPITAL

More information

Institutional Handbook of Operating Procedures Policy

Institutional Handbook of Operating Procedures Policy Section: Admission, Discharge, and Transfer Institutional Handbook of Operating Procedures Policy 9.1.29 Responsible Vice President: EVP & CEO Health System Subject: Admission, Discharge, and Transfer

More information

Painful Infusions of Potassium A Potassium Protocol. Eve Holderman, BSN, RN, CPAN October 21, 2017 NYSPANA State Conference

Painful Infusions of Potassium A Potassium Protocol. Eve Holderman, BSN, RN, CPAN October 21, 2017 NYSPANA State Conference Painful Infusions of Potassium A Potassium Protocol Eve Holderman, BSN, RN, CPAN October 21, 2017 NYSPANA State Conference Objective To identify strategies for intervention when the patient experiences

More information

Medical Review Criteria Skilled Nursing Facility & Subacute Care

Medical Review Criteria Skilled Nursing Facility & Subacute Care Medical Review Criteria Skilled Nursing Facility & Care Subject: Skilled Nursing Facility and Care Background: Skilled nursing facilities () provide facility-based skilled nursing care and related services

More information

Infusion Therapy from Hospital to Home Bridging the Gap. Lisa A. Gorski RN, MS, HHCNS-BC, CRNI, FAAN

Infusion Therapy from Hospital to Home Bridging the Gap. Lisa A. Gorski RN, MS, HHCNS-BC, CRNI, FAAN Infusion Therapy from Hospital to Home Bridging the Gap Lisa A. Gorski RN, MS, HHCNS-BC, CRNI, FAAN Disclosures Have been compensated for presentations by BD Medical, 3M, Access Scientific, Genentech Advisory

More information

CENTRAL IOWA HEALTHCARE Marshalltown, Iowa

CENTRAL IOWA HEALTHCARE Marshalltown, Iowa CENTRAL IOWA HEALTHCARE Marshalltown, Iowa CARE OF PATIENT POLICY & PROCEDURES Policy Number: 4.37 Subject: Implanted Venous Access Device (Infus-A-Port), Nursing Management Of (Indwelling Vascular Access

More information

Educational Goals & Objectives

Educational Goals & Objectives Educational Goals & Objectives Primary care physicians are involved with patients over the course of their lives. Many of these patients will develop serious and/or life-threatening illnesses that affect

More information

The CMS State Operations Manual Overview and Changes

The CMS State Operations Manual Overview and Changes The CMS State Operations Manual Overview and Changes Omnicare, Inc. Page 1 Overview of the CMS State Operations Manual Executive Summary Historical Perspective The Requirements Pharmacy Services Labeling

More information

STANDARDIZED PROCEDURE NEONATAL / PEDIATRIC INTRAOSSEOUS LINE PLACEMENT (Neonatal, Pediatric)

STANDARDIZED PROCEDURE NEONATAL / PEDIATRIC INTRAOSSEOUS LINE PLACEMENT (Neonatal, Pediatric) I. Definition To place a large bore needle into the bone marrow for the purpose of emergency access for fluids and medications. II. Background Information A. Setting: Inpatient neonatal / pediatric patients

More information

Presented by: Mary Ann Knee RN,CRNI, COS-C

Presented by: Mary Ann Knee RN,CRNI, COS-C Presented by: Mary Ann Knee RN,CRNI, COS-C 64B9-12.002 Definitions. (1) Administration of Intravenous Therapy is the therapeutic infusion and/or injection of substances through the venous peripheral system,

More information

STANDARDIZED PROCEDURE HEPATIC ARTERY INFUSION OF CHEMOTHERAPY (Adults, Peds)

STANDARDIZED PROCEDURE HEPATIC ARTERY INFUSION OF CHEMOTHERAPY (Adults, Peds) I. Definition Hepatic arterial infusion (HAI) of chemotherapy is accomplished by a small drug delivery system or pump that is implanted in a subcutaneous pocket in the lower abdomen. The pump reservoir

More information

THE NEUMA PICC AND CENTRAL LINE PROTECTION CLAMP Introduction and Frequently Asked Questions

THE NEUMA PICC AND CENTRAL LINE PROTECTION CLAMP Introduction and Frequently Asked Questions BACKGROUND The use of central lines for medical treatment is accelerating alongside an epidemic of intravenous drug abuse and opioid overdoses. Medical facilities are experiencing a dramatic need for safe

More information

Infusion Therapy Learning Exercise: Infusion Documentation

Infusion Therapy Learning Exercise: Infusion Documentation Infusion Therapy Learning Exercise: Infusion Documentation INFUSION OF DOCUMENT IN DOCUMENT PERIPHERAL PICC LINE BLOOD TRANSFUSION SPINAL EPIDURAL CLPNA Infusion Therapy: Infusion Documentation Exercise

More information

TITLE/DESCRIPTION: IODINATED C0NTRAST MEDICATION ADMINISTRATION

TITLE/DESCRIPTION: IODINATED C0NTRAST MEDICATION ADMINISTRATION TITLE/DESCRIPTION: IODINATED C0NTRAST MEDICATION ADMINISTRATION PROCEDURE DEPARTMENT: Radiology PERSONNEL: All Personnel in Radiology EFFECTIVE DATE: March 2008 REVISED: Feb 2012, 1/15, 05/17 POLICY: IODINATED

More information

2010 PQRI REPORTING OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

2010 PQRI REPORTING OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY Measure #193: Perioperative Temperature Management 2010 PQRI REPTING OPTIONS F INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage of patients, regardless of age, undergoing surgical or therapeutic

More information

Administration of Medications A Self-Assessment Guide for Licensed Practical Nurses

Administration of Medications A Self-Assessment Guide for Licensed Practical Nurses Administration of Medications A Self-Assessment Guide for Licensed Practical Nurses March 2018 College of Licensed Practical Nurses of Nova Scotia http://clpnns.ca Starlite Gallery, 302-7071 Bayers Road,

More information

Saving Lives: EWS & CODE SEPSIS. Kim McDonough RN and Margaret Currie-Coyoy MBA Last Revision: August 2013

Saving Lives: EWS & CODE SEPSIS. Kim McDonough RN and Margaret Currie-Coyoy MBA Last Revision: August 2013 Saving Lives: EWS & CODE SEPSIS Kim McDonough RN and Margaret Currie-Coyoy MBA Last Revision: August 2013 Course Objectives At the conclusion of this training, you will be able to Explain the importance

More information

How Do We Choose Optimal PIV Sites? Objectives. Good Vein, Bad Vein NIR & Choosing the Best IV Access Site. INS Site Choice Advice Key Points

How Do We Choose Optimal PIV Sites? Objectives. Good Vein, Bad Vein NIR & Choosing the Best IV Access Site. INS Site Choice Advice Key Points Good Vein, Bad Vein NIR & Choosing the Best IV Access Site Greg Schears, MD Mayo Clinic, Rochester, MN Objectives Identify what is known regarding optimal PIV sites in guidelines and the literature Discuss

More information

McKinley T34 Ambulatory syringe pump Used in the provision of adult palliative and end of life care

McKinley T34 Ambulatory syringe pump Used in the provision of adult palliative and end of life care Health Guidance McKinley T34 Ambulatory syringe pump Used in the provision of adult palliative and end of life care Publication Code: HCR-0214-083 Publication date: 26 February 2014 Page 1 of 7 Health

More information

Clinical Fellowship Acute Pain Service

Clinical Fellowship Acute Pain Service Anesthesia and Perioperative Medicine Western University Acute Pain Service Program Directors Dr. Kevin Armstrong Dr. Qutaiba Tawfic Please visit the Acute Pain Service Fellowship site for most up-to-date

More information

PREPARATION AND ADMINISTRATION

PREPARATION AND ADMINISTRATION LESSON PLAN: 12 COURSE TITLE: UNIT: IV MEDICATION TECHNICIAN PREPARATION AND ADMINISTRATION SCOPE OF UNIT: Guidelines and procedures for preparation, administration, reporting, and recording of oral, ophthalmic,

More information

Intravenous Epoprostenol (Flolan) Therapy

Intravenous Epoprostenol (Flolan) Therapy National Pulmonary Hypertension Service Intravenous Epoprostenol (Flolan) Therapy This information is intended only to be a guide to what you can expect when you start intravenous Flolan treatment. If

More information

Patient Controlled Analgesia Guidelines

Patient Controlled Analgesia Guidelines Patient Controlled Analgesia Guidelines Date: August 2005 Ref : PCD005 Vers : 2 Policy Profile Policy Reference Number PCD005 Version 2 Status Approved Trust Lead Director of Nursing/Acute Pain Team Implementation

More information

Objectives. Vessel Health and Preservation: Disclosure. Ms. Moureau has disclosed the following: Angiodynamics, Genentech

Objectives. Vessel Health and Preservation: Disclosure. Ms. Moureau has disclosed the following: Angiodynamics, Genentech Vessel Health and Preservation: What is the Right Line for the Right Patient at the Right Time? Nancy Moureau, BSN, RN, CRNI, CPUI, VA-BC This program is sponsored by Teleflex Saxe Communications 2012

More information

Symptom Relief Kit. Guidelines

Symptom Relief Kit. Guidelines Symptom Relief Kit Guidelines Hospice Palliative Care Teams for Central LHIN August 20, 2015 Hospice Palliative Care Teams for Central LHIN 1 Table of Contents 1. Definition... 3 2. Why Order a SRK?...

More information

CARE OF THE PATIENT REQUIRING CONTINUOUS FLOLAN INFUSION GUIDELINE

CARE OF THE PATIENT REQUIRING CONTINUOUS FLOLAN INFUSION GUIDELINE Page Number: 1 of 5 TITLE: CARE OF THE PATIENT REQUIRING CONTINUOUS FLOLAN INFUSION GUIDELINE PURPOSE: To provide guidelines for the nursing care of the patient with a Flolan infusion delivered thru continuous

More information

Nurse Orientation. Medication Management

Nurse Orientation. Medication Management Nurse Orientation Medication Management Objectives Discuss basic principles/rights of medication administration, according to your site policy Describe principles of patient/family education related to

More information

Instruction Guidelines

Instruction Guidelines Instruction Guidelines For the Caring Safely at Home Resources and Educational Framework BRISBANE SOUTH PALLIATIVE CARE COLLABORATIVE 2016 Background Palliative care services strive to support patients

More information

Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care, and Pain Medicine Rotation: Post Anesthesia Care Unit (CA-1, CA-2, CA-3)

Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care, and Pain Medicine Rotation: Post Anesthesia Care Unit (CA-1, CA-2, CA-3) Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care, and Pain Medicine Rotation: Post Anesthesia Care Unit (CA-1, CA-2, CA-3) Goals GOALS AND OBJECTIVES To analyze and interpret

More information

Palliative and Hospice Care In the United States Jean Root, DO

Palliative and Hospice Care In the United States Jean Root, DO Palliative and Hospice Care In the United States Jean Root, DO Hello. My name is Jean Root. I am an Osteopathic Physician who specializes in Geriatrics, or care of the elderly. I teach and practice Geriatric

More information

Intravenous Injection of Contrast Media COMPETENCY PROFILE. Prepared by The Ontario Association of Medical Radiation Sciences

Intravenous Injection of Contrast Media COMPETENCY PROFILE. Prepared by The Ontario Association of Medical Radiation Sciences Intravenous Injection of Contrast Media COMPETENCY PROFILE Prepared by The www.oamrs.org Assumptions Assumed prerequisite knowledge, skills and professional attributes: The Participant: 1. Has completed

More information

Why Iron? Iron is the Most prevalent micronutrient deficiency in the world (WHO 1968)

Why Iron? Iron is the Most prevalent micronutrient deficiency in the world (WHO 1968) Why Iron? Iron is the Most prevalent micronutrient deficiency in the world (WHO 1968) Iron deficiency anaemia is a Major reason for blood being transfused Iron deficiency without anaemia is 3 times as

More information

Pediatric Math. Review of formulas: On hand: vehicle:: desired dose : x CONVERTING POUNDS TO KILOGRAMS: 2.2 pounds (lb) = 1kilogram (kg)

Pediatric Math. Review of formulas: On hand: vehicle:: desired dose : x CONVERTING POUNDS TO KILOGRAMS: 2.2 pounds (lb) = 1kilogram (kg) Pediatric Math Children are more susceptible to medications than adults due to immature systems, metabolism and physical composition that can alter the pharmacokinetics of drugs. Therefore it is essential

More information

Administration of IV Medication in the Community by the Children s Community Nursing Team Standard Operating Procedure

Administration of IV Medication in the Community by the Children s Community Nursing Team Standard Operating Procedure Administration of IV Medication in the Community by the Children s Community Nursing Team Standard Operating Procedure DOCUMENT CONTROL: Version: 1 Ratified by: Clinical Quality and Standards Group Date

More information

Nursing Home Pearls or

Nursing Home Pearls or Nursing Home Pearls or How to Enjoy Practicing in Skilled Nursing Facilities Lowell C. Dale, MD November 11, 2016 2016 MFMER slide-1 DISCLOSURE Relevant Financial Relationship Medical Director Golden Living

More information

Maryland MOLST for the Health Care Practitioner. Maryland MOLST Training Task Force July 2013

Maryland MOLST for the Health Care Practitioner. Maryland MOLST Training Task Force July 2013 Maryland MOLST for the Health Care Practitioner Maryland MOLST Training Task Force July 2013 What is the Health Care Decisions Act? Health Care Decisions Act Applies in all health care settings and in

More information

SUBCHAPTER 16Q - GENERAL ANESTHESIA AND SEDATION SECTION.0100 DEFINITIONS

SUBCHAPTER 16Q - GENERAL ANESTHESIA AND SEDATION SECTION.0100 DEFINITIONS SUBCHAPTER 16Q - GENERAL ANESTHESIA AND SEDATION SECTION.0100 DEFINITIONS 21 NCAC 16Q.0101 GENERAL ANESTHESIA AND SEDATION DEFINITIONS For the purpose of these Rules relative to the administration of minimal

More information

Primum Computer-based Case Simulations (CCS) Frequently Asked Questions (FAQs)

Primum Computer-based Case Simulations (CCS) Frequently Asked Questions (FAQs) Primum Computer-based Case Simulations (CCS) Frequently Asked Questions (FAQs) 1. What are my responsibilities? You should function as a primary care physician and maintain responsibility for the patient

More information

CNA SEPSIS EDUCATION 2017

CNA SEPSIS EDUCATION 2017 CNA SEPSIS EDUCATION 2017 WHAT CAUSES SEPSIS? Sepsis occurs when the body has a severe immune response to an infection Anyone who has an infection is at risk for developing sepsis Sepsis occurs when the

More information

Derby Hospitals NHS Foundation Trust. Drug Assessment

Derby Hospitals NHS Foundation Trust. Drug Assessment Drug Assessment for Preparation and Administration of Oral, Enteral, Ophthalmic, Topical, PR, PV, Inhaled, Subcutaneous and Intramuscular Medicines to Patients (N.B. The preparation and administration

More information

Georgian College of Applied Arts & Technology

Georgian College of Applied Arts & Technology Georgian College of Applied Arts & Technology Program Outline (Effective Fall 2005) RN Nephrology Nursing (Post Basic Certificate) Program Code: H662 Ministry Approval Date: March 24, 2000 Ministry Code:

More information

Wyoming STATE BOARD OF NURSING

Wyoming STATE BOARD OF NURSING David D. Freudenthal Governor Wyoming STATE BOARD OF NURSING Mary Kay Goetter, PhD, RNC, NEA-BC Executive Director 1810 Pioneer Avenue Cheyenne, Wyoming 82002 Phone: 307-777-7601 FAX: 307-777-3519 http://nursing.state.wy.us

More information

VIRGINIA ADVANCE DIRECTIVE FOR HEALTH CARE

VIRGINIA ADVANCE DIRECTIVE FOR HEALTH CARE This advance directive ( AD ) complies with the Virginia Healthcare Decisions Act. You are not required to use this form to create an AD. If you choose to use a different form, you should consult with

More information

Subject: Skilled Nursing Facilities (Page 1 of 6)

Subject: Skilled Nursing Facilities (Page 1 of 6) Subject: Skilled Nursing Facilities (Page 1 of 6) Objective: I. To ensure that Tuality Health Alliance (THA) and delegated Providence Health Plan Medicare members are appropriately placed in skilled nursing

More information

Summit ElderCare. Each participant will receive his or her primary medical care from a PACE medical provider.

Summit ElderCare. Each participant will receive his or her primary medical care from a PACE medical provider. PA-SE-005-003 PROVISION OF PRIMARY CARE SERVICES Purpose: Each participant will receive his or her primary medical care from a PACE medical provider. Policy: Each participant has a primary care physician

More information

Routine vs. Clinically Indicated Peripherally Inserted Intravenous Catheter Changes

Routine vs. Clinically Indicated Peripherally Inserted Intravenous Catheter Changes Lehigh Valley Health Network LVHN Scholarly Works Patient Care Services / Nursing Routine vs. Clinically Indicated Peripherally Inserted Intravenous Catheter Changes Juliet Hahn BSN, RN Lehigh Valley Health

More information

STANDARDIZED PROCEDURE INFRARED COAGULATION THERAPY (Adults, Peds)

STANDARDIZED PROCEDURE INFRARED COAGULATION THERAPY (Adults, Peds) I. Definition Infrared Coagulation (IRC) Therapy is a treatment for anogenital warts, low grade squamous intraepithelial neoplasia (LGAIN) or high grade squamous intraepithelial neoplasia (HGAIN). IRC

More information

Mandatory Competency Assessment for Medicines Management (Not Injectable Medicines) for Registered Practitioners IN HOSPITAL

Mandatory Competency Assessment for Medicines Management (Not Injectable Medicines) for Registered Practitioners IN HOSPITAL Mandatory Competency Assessment for Medicines Management (Not Injectable Medicines) for Registered Practitioners IN HOSPITAL Document Author Written by: Lead Pharmacist/Lead Technician Medicines Use and

More information

Department of Nursing

Department of Nursing Department of Nursing Nursing 220: Professional Clinical Nursing Practice Five Course Credits Spring: 12 Week 2012 Tuesday 2-4 (Classroom Learning) 24 total hours Wednesday 8:30-11:30 or 1-4 (Lab Learning)

More information

Advancing IV Therapy: national update and developments

Advancing IV Therapy: national update and developments Advancing IV Therapy: national update and developments Dr Lisa Dougherty Nurse Consultant IV Therapy 1 2 Aim of Session To provide an overview of how new technologies, techniques and roles have improved

More information

TheValues History: A Worksheet for Advance Directives Courtesy of Somerset Hospital s Ethics Committee

TheValues History: A Worksheet for Advance Directives Courtesy of Somerset Hospital s Ethics Committee TheValues History: A Worksheet for Advance Directives Courtesy of Somerset Hospital s Ethics Committee Advance Directives Living Wills Power of Attorney The Values History: A Worksheet for Advanced Directives

More information

21 st Century Health Care Consultants

21 st Century Health Care Consultants 21 st Century Health Care Consultants Presents 1 Investing in your Infusion Specialty Program Presented by: Rhonda Surgnier RN Becky Tolson RN David Kachel CRNI INFUSION THERAPY OBJECTIVES 2 At the completion

More information

Methods available for the delivery of medicines to patients

Methods available for the delivery of medicines to patients Chapter 1 Methods available for the delivery of medicines to patients A number of different methods are available to healthcare professionals for the delivery of medicines to patients. These methods include

More information

Rita Shane, Pharm.D., FASHP, FCSHP Chief Pharmacy Officer Cedars-Sinai Medical Center Asst. Dean, Clinical Pharmacy, UCSF School of Pharmacy

Rita Shane, Pharm.D., FASHP, FCSHP Chief Pharmacy Officer Cedars-Sinai Medical Center Asst. Dean, Clinical Pharmacy, UCSF School of Pharmacy Rita Shane, Pharm.D., FASHP, FCSHP Chief Pharmacy Officer Cedars-Sinai Medical Center Asst. Dean, Clinical Pharmacy, UCSF School of Pharmacy Describe the transformation of health-systems in response to

More information

Top 10 audio questions

Top 10 audio questions Top 10 audio questions Question 1 Scenario: A patient is admitted to the ED for acute abdominal pain. The documentation states that he receives the following: Infusion normal saline, 22:30 Zofran IV push,

More information

ADMISSION CARE PLAN. Orient PRN to person, place, & time

ADMISSION CARE PLAN. Orient PRN to person, place, & time ADMISSION DATE: CODE STATUS: ADMISSION CARE PLAN ADMISSION DIAGNOSIS: 1. DELIRIUM 2. COGNITIVE LOSS Resident will be as alert and oriented as possible Resident will be as alert and oriented as comfortable

More information

During the hospital medicine rotation, residents will focus on the following procedures as permitted by case mix:

During the hospital medicine rotation, residents will focus on the following procedures as permitted by case mix: Educational Goals & Objectives The Inpatient Family Medicine rotation will provide the resident with an opportunity to evaluate and manage patients with common acute medical conditions. Training will focus

More information

Skilled Nursing Facility Admission Orders

Skilled Nursing Facility Admission Orders Diagnosis Allergies SNF Admission- Required SNF Regulatory Admit to Skilled Nursing Facility Date: All orders good for 45 days unless otherwise indicated Follow Up Appointment Follow up appointment(s):

More information

Medication Errors in Chemotherapy PORSCHA L. JOHNSON, PHARM.D. CLINICAL PHARMACIST II MEDSTAR WASHINGTON HOSPITAL CENTER SATURDAY, SEPTEMBER 17, 2016

Medication Errors in Chemotherapy PORSCHA L. JOHNSON, PHARM.D. CLINICAL PHARMACIST II MEDSTAR WASHINGTON HOSPITAL CENTER SATURDAY, SEPTEMBER 17, 2016 Medication Errors in Chemotherapy PORSCHA L. JOHNSON, PHARM.D. CLINICAL PHARMACIST II MEDSTAR WASHINGTON HOSPITAL CENTER SATURDAY, SEPTEMBER 17, 2016 DISCLOSURE STATEMENT I have nothing to disclose regarding

More information

Technology Innovations in Vascular Access

Technology Innovations in Vascular Access Technology Innovations in Vascular Access Nancy Moureau, BSN, CRNI PICC Excellence, Inc. nancy@piccexcellence.com Introduction My experience RN for 35 years PICC Instructor and inserter 26 years As a trainer

More information

Peripherally Inserted Central Catheter

Peripherally Inserted Central Catheter UW MEDICINE PATIENT EDUCATION Peripherally Inserted Central Catheter Understanding your PICC procedure and consent form Please read this handout before reading and signing the form Special Consent for

More information

Monitoring Medication Storage & Administration

Monitoring Medication Storage & Administration Monitoring Medication Storage & Administration Objectives Review F-Tags pertaining to medication management Discuss proper medication storage and administration Understand medication cart and medication

More information

CLINICAL GUIDELINE FOR THE USE OF RECTUS SHEATH CATHETERS IN CHILDREN. 1. Aim/Purpose of this Guideline

CLINICAL GUIDELINE FOR THE USE OF RECTUS SHEATH CATHETERS IN CHILDREN. 1. Aim/Purpose of this Guideline CLINICAL GUIDELINE FOR THE USE OF RECTUS SHEATH CATHETERS IN CHILDREN. 1. Aim/Purpose of this Guideline 1.1. Guidelines for the use of rectus sheath catheters for the management of pain following laparotomy

More information

COURSE INFORMATION FORM

COURSE INFORMATION FORM DATE SUBMITTED 6/24/13 CATALOG NO. PNUR 136 DATE DICC APPROVED 9/24/2013 DATE LAST REVIEWED 8/25/2009 DISCIPLINE COURSE TITLE COURSE INFORMATION FORM Practical Nursing Venous Access and Intravenous Infusion

More information

Strategy/Driver Prevention Strategies Action Strategies

Strategy/Driver Prevention Strategies Action Strategies I. Hospital executive leadership commitment to prevention of surgical site infections 1. Establish Surgical Site Infection prevention as a strategic priority 2. Develop and implement business/strategic

More information