Clinical Education Update, October 2013

Transcription

1 Clinical Education Update, October 2013 In this Issue: Editors: Mary Welly, RN, BC, BSN Vivian Norman, RN, MSN, CCRN Formatting Editor: Phyllis Sharum Editor s Notes Save the Date! Celebrating the Success of our Staff 2013 Scholarship Recipients Caritas Leadership 4 & 5 GEM Awards 6 HeartCode Instructions BLS Scheduled for Nights New Compression Devices & 8 9 E DITOR S N OTES From the bedside to the boardroom, change is palpable: department moves, new competencies, new processes for admission and discharge, new products; department mergers, staff transfers and new patient populations to care for. Remember to stop and breathe take care of yourself. Be aware of your stress level and ways to reduce stress. What works for one might be different for another person. We are St. Joseph Hospital, and we take every challenge with pride and dignity to continue to achieve our excellent outcomes. We do not just care for our patients, we care for each other. One opportunity for self-care was developed by the End of Life Committee. Healing the Healer will be offered on November 1 st, 8:00 12:00. (details and sign up on Health Stream) Remember Caritas Process #10: Be Open to Mystery and Allow Miracles to Enter. Mary Welly & Vivian Norman October CEU Editors DNAR Order Form Key Points from CVC Guidelines Adult Central Venous Catheter (CVC) Guidelines Burlew s Clues Computer Class Schedule Policies & Procedures & & 16

2 Page 2 CELEBRATING THE SUCCESS OF OUR STAFF Critical Care: Amy Aguilar, RN, MICU, completed her BSN from California State University, Fullerton. Krisi Gordon, MICU, received her CCRN certification Surgical Services: Judy Handelsman RN, Main OR graduated with a BSN from California State University, Fullerton Emergency Department: Ivy Whitford, RN received her MSN from Western University Tajinder Pahal, RN received her BSN from California State University Fullerton Alejandra De La Rosa, RN received her BSN from Drexel University Soledad Mathus, RN received her BSN from University of Phoenix Behavioral Health: Libay Luriz, RN, Clinical Coordinator received her ANCC certification in psychiatric and mental health nursing Jeannine Loucks, RN, MSN received her POST (police officer standardized training) certification. Jeannine has been involved in educating police about behavioral health patients that they may encounter in the course of their duties. Mother Baby Unit: Lalaine Natividad RNC earned her RNC in Maternal Newborn Nursing Linda Page RNC, earned her RNC in Maternal Newborn Nursing Lucy Zuniga RNC, earned her RNC in Maternal Newborn Nursing L&D: Jennifer Branson OBT, CST earned her Certification in Surgical Technology Rachel Lee RNC, BSN earned her RNC in Inpatient OB New!!! SJO is embarking on a goal to improve our blood management. We are kicking off this initiative with inservices Transfusion Safety in the 21 st Century. More education will follow in the coming months. Get informed with this new evidence-based practice change.

3 2013 SCHOLARSHIP RECIPIENTS Page 3 Back row: August Maggio, Alice Paone, RN scholarship; Arbert Mazareno, Madeline Colette Seeds, RN Advance Practice Nurse scholarship; Danielle Stelly, Sister Frances Dunn scholarship; Branden Parker, Thomas J Dorsey, MD scholarship; Soudi Bogert, Larry Ainsworth Leadership scholarship; Alvaro Portillo, Sister Frances Dunn scholarship; John Samai, Alice Paone, RN scholarship Front row: Maharlika Atienza, Dominick Gentile, MD scholarship; Carolina de Mendoza, Dominick Gentile, MD scholarship; Not shown: Jenny Ly, Alice Paone, RN scholarship Have you been thinking of returning to school to obtain your BSN or MSN? St. Joseph Hospital wants to make this easier for you. Please join us for a Lunch & Learn session: We have assembled a panel of St. Joseph Hospital RNs from a variety of nursing programs. The panel will share their personal experiences and answer your questions about returning to school as an adult learner. Lunch will be provided. What: Panel of SJH Staff RNs sharing experiences & answering questions about returning to school When: October 23, :30pm Where: Sr. Frances Dunn, Classroom 7

4 Page 4 Caritas Leadership J EAN WATSON S THEORY OF HUMAN CARING There are many leadership theories, such as Transformational Leadership, Transactional Leadership, Servant Leadership, Kouzes - Posner s Leadership Model and Relationship-Based Care Model. Facilitative Leadership provides a guide to behavior. Each of these theories and models has a place, a purpose to assist leaders to do a better job at leading. The leadership literature has been calling for more, for more caring in leadership; for more purpose in leadership. I keep coming back to Jean Watson. When one thinks of the Theory of Human Caring, it brings to mind the nurse/patient interaction, and application of the theory is clearly evidenced in this human relationship. There is a synergy between the caregiver and the one being cared-for. It is a two-way relationship. Yes, we caregivers give to our patients, but we also receive so much from our patients. We grow deeper in our commitment to heal, in our capacity to love Caritas. Each of the aforementioned leadership theories address the leader, what the leader should do, how the leader should lead, and describe more of a pattern of leading behaviors and attitudes and tasks. Perhaps what is needed in leadership theory is the same depth of caring that we have for our patients, translated / transferred to the caregivers that we lead; more purpose and depth and return, more reinforcement for the leader s growth. Your name tag does not have to have a management title on it for you to be a leader. Every department has formal and informal leaders. Each of us has the capacity to lead in certain circumstances. The core principles of Jean Watson s Theory of Human Caring, with leadership application: Practice of loving kindness and equanimity: leaders need to show their vulnerabilities, their humanness to reflect their strength of character. The loving-kindness shown by the St. Joseph leaders every day demonstrates this. Equanimity (inner peace, calmness) is essential when leaders are dealing with crisis situations. The ability to have equanimity during stressful times enables the leader to retain their ability to listen and to use logic and clear communication to navigate the crisis and resolve the issue/conflict Authentic Presence; enabling deep belief of other: when you ask people what makes a great leader, inevitably a clear communicator, fair, good listener are all near the top of the list of characteristics that make a great leader. Authentic presence is being in the now with a total focus on the issue at hand. When an employee comes to their boss, if the boss is able to really listen and focus on their issue, the employee feels important, feels that they are cared for and that they are important to the organization. Authentic presence demonstrates that the leader believes in the employee, and helps to give the employee a sense of purpose and a reason to believe in themselves and the mission of the organization. (Continued on page 5)

5 (Continued from page 4) Page 5 Cultivation of one s own spiritual practice: Leadership/management is very stressful and not everyone is able to handle the daily stress of managing. Dealing with incidents, scheduling, census fluctuations, patient/ family complaints, staff concerns, budgets, changes the list goes on and on. Leaders must cultivate a method of handling the stress, they have to be able to renew, regenerate their strength. In other words, to find their source of strength. Their personal meaning of spirituality. We are bodymindspirit, indivisible, which makes each of us a unique individual. The ability to rejuvenate our strength, to renew our energy is essential. If we do not have a way to recharge our batteries, we will fizzle out and become an ineffective leader, who brings biotoxic energy to the workplace. Being the caring-healing environment: Each of us has energy that surrounds us, and we put it out into the environment. We try to put out positive energy, but at times, our mood, emotions, thoughts, feelings may become negative and others can actually feel this. We need to be able to assist those around us to maintain a caring-healing environment for our patients. The first step starts with an awareness of the importance of our authentic presence, our spirituality, our being. Allowing for miracles: Miracles: the unexpected, the unexplained occur every day. A leader s awareness of the miracles all around us, and his/her ability to celebrate these miracles can be the difference between a healthy and unhealthy work environment. Role modeling is an important aspect of leadership. Seeing miracles, pointing them out and celebrating them with staff can be one of the most important things that a leader can do. Vivian Norman, RN, MSN, CCRN Caritas Coach To be human is to feel. All too often we allow ourselves to think our thoughts but not feel our feelings. The primary way to develop sensitivity and a need for spiritual practices is to pay attention to our feelings and thoughts painful as well as happy ones. Jean Watson

6 Page 6 GEM Awards Giving Excellence Meaning Nurse.com publication nursing excellence program honors nurses and the extraordinary contributions they make to patients and the profession. It is unique in the fact that the nurses are nominated by nurses, selected by nurses and honored by nurses. SJO is proud to have two finalists this year Darcie Peterson, ANP-BC,CWOCN-AP, Enterostomal Therapist, in the category of Clinical Care Inpatient. This is awarded to an RN who demonstrates superior clinical nursing knowledge and expert skills, and applies both in ways that measurably impact the quality of care and improve patient care outcomes in any inpatient clinical setting or nursing specialty. Vivian Norman, RN, MSN, CCRN, Clinical Educator, regional finalist in the category of Education & Mentorship. This is awarded to an RN who contributes to nursing s body of knowledge through formal nursing education, skills training or continuing education, or who guides, supports or influences nurses career development in meaningful, measurable ways through the art of professional nursing.

7 Who: What: Online Course & Skills Validation HeartCode = BLS Renewal All employees renewing BLS AHA Health Care Provider Cards This online renewal course will provide the current BLS provider with review of AHA Basic Life Support followed by online testing. Upon successful completion of the HeartCode cognitive component you will schedule a 30 minute Skills Practice & Validation Session on HealthStream. When: July 1, 2013 How: The HeartCode BLS Renewal Course includes 2 parts: 1. Online content, including test, and 2. Skills Practice & Validation with a BLS instructor To enroll in this course on HealthStream go to OR go to SJO Clinical Applications Page 7 Once logged into HealthStream, select Catalog, search HeartCode BLS Renewal Course 2013 Once enrolled in the HeartCode BLS Renewal Course 2013, you must: Register for HeartCode BLS Renewal Skills Practice & Validation: Register to attend one 30- minute BLS Skills Practice & Validation session (see schedule on HealthStream) After you register for the skills practice & validation session, select the online exam - HeartCode BLS Part 1 -G2010. Complete the module, examination & evaluation prior to skills practice & validation session. Bring certificate of completion to the BLS Renewal Skills Practice and Validation. kills The HeartCode Online BLS Course & Exam must be successfully completed prior to Skills Practice & Validation Session. Important When BLS Part 1 G2010 (Online Test) is completed the certificate is only good for 60 days. Requirements: Skills Practice & Validation must be completed within 60 days of certificate completion. Headphones: The e-learning lab is available for test taking. Headphones can be checked out from Clinical Education, M-F 8-4:30pm. Late arrivals will not be able to participate in Skills Practice And Validation Session. For HealthStream questions, contact the Clinical Education Department at ext Technical Requirements: Turn off pop-up blockers HealthStream recommends using Windows based computer system with Internet Explorer. Computer with speakers or Headphones Note: The HeartCode BLS course & exam must be successfully completed prior to attending the HeartCode BLS Skills Validation.

8 Page 8 HeartCode: BLS Renewal Course Registration Process Step 1: To find HealthStream to enroll in this course go to SJO Clinical Applications. Once logged into HealthStream, select the Catalog tab, in search box type in HeartCode to find HeartCode BLS Renewal Course 2013 click on blue link to Continue. Step 2A: Select the HeartCode BLS Renewal Course 2013 link, Click enroll. Step 2B: Select the HeartCode BLS Renewal Course 2013 link, Click enroll. Once enrolled, complete three learning activities to complete registration. 1.) Open HeartCode Student Guide and review. 2.) Answer two questions on current card and identity validation. 3.) Register to attend one 30-minute skills validation session. Step 2C: Select Return (upper right corner) and then select Exit Course this will return you to the next step to the online test (HeartCode BLS Part 1 G-2010). Select enroll and start the review practice videos, simulations, test, and evaluation. Once HeartCode BLS Part 1 G2010 is completed and test is passed print certificate and bring to skills validation session. Step 3: Attend the HeartCode BLS Skills Practice & Validation with a BLS instructor to demonstrate your skills at your pre-scheduled validation. Upon successful completion, the BLS card will be issued. Note: The HeartCode BLS course & exam must be successfully completed prior to attending the HeartCode BLS Skills Validation.

9 Page 9 BLS IS COMING TO NIGHTS! You can now complete your skills demonstration during the night shift You will need to: Complete the HeartCode Course on HealthStream Bring your certificate of completion Sign up on HealthStream for skills demonstration October dates: 10 th and 24 th Times: 11pm or 12midnight ***Additional classes to be scheduled...check HealthStream The New Compression Devices are Here! Things to Remember: The machines stay in the room and DO NOT move with the patient. The machines stay in the room and DO NOT come from Central unless your machine is broken / unusable and there is no PAR level in the unit. The machines stay in the room and DO NOT go to the dirty utility room. EVS cleans the machines in the room (like oximeters). The sleeves are interchangeable; leg, calf, and foot sleeves all use the same machine. Each unit needs to stock PAR levels of sleeves they use most. Do not label the machines.

10 Page 10 Key points from the revised Adult Central Venous Catheter (CVC) Guidelines GOAL: Eliminate CLABSI (Central Line Associated Blood Stream Infections) Flush all lumens of all central lines whether IV infusing or capped with 10mL Normal Saline every 8 hours to ensure patency. Check line patency by aspirating prior to use. Withdraw and discard 5 ml prior to blood specimen collection. If unable to flush or aspirate, contact physician for orders to declot using tpa per guidelines in IV301. (let pharmacy know how many syringes to dispense) Dressing is still changed every Sunday & prn Tubing/caps are still changed every Monday & Wednesday Curos caps are used on all IVs in MICU & DSU, may go housewide soon. Wear gloves every time you touch IV tubings Review IV 301 for complete CVC care guidelines Section A: This section applies when the patient has no pulse and is not breathing. The patient will be allowed to die naturally. Section B: This section applies when the patient has a pulse and/or is breathing these are pre-arrest interventions There are two treatment choices in Section B: Comfort Measures OR Limited Interventions. One MUST be selected. Note the MET Team will need to be called to initiate the Limited Interventions The flushing order set is available on Clinical Applications icon ; Physician Resources ; Medications ; Central Venous Catheter Care. By initiating this secondary order set, the flushing guidelines will be in the EMR

11 Adult Central Venous Catheter (CVC) Guidelines Page 11 Check line patency by aspirating prior to use. Withdraw and discard 5 ml prior to blood specimen collection. If IV infusing, flush all lumens of central lines Q 8 Hrs following flushing protocol below, unless vasoactive medication infusing may cause hemodynamic compromise if flushed. If line is capped, follow flushing protocol below. For partial or complete occlusion, obtain order from physician to declot with tpa. Please note the number of lumens that need to be declotted so pharmacy knows how many syringes to dispense. Dressing change with biopatch every Sunday & prn C ATHETER T YPE Short Term CVC (eg. Triple lumen) PICC no heparin required PICC that requires Heparin Indwelling / Tunneled (Hickman/Broviac) Indwelling / Tunneled (Groshong) Implanted Port Pulmonary Artery Catheter / Arterial Line Dialysis Catheter: Short and Long Term F LUSHING PROTOCOL Normal Saline Flush 10 ml after each use and each lumen Q 8 Hrs, when IV infusing and when capped. Heparin (100 units/ml) 1mL following normal saline flush after each use and each lumen Q 8 Hrs when capped. Normal Saline Flush 10 ml Q 8 Hrs when IV infusing. Normal Saline Flush 10 ml after each use and each lumen Q 8 Hrs when capped. NO heparin required. Normal Saline Flush 10 ml Q 8 Hrs when IV infusing. Normal Saline Flush 10 ml after each use and each lumen Q 12 Hrs when capped. Heparin (100 units/ml) 1 ml following normal saline flush after each use and each lumen Q 12 Hrs when capped. Normal Saline Flush 10 ml Q 8 Hrs when IV infusing. Normal Saline Flush 10 ml after each use and each lumen Q 24 Hrs when capped. Heparin (100 units/ml) 3 ml following normal saline flush after each use and each lumen Q24 Hrs when capped. Normal Saline Flush 10 ml Q 8 Hrs when IV infusing. Normal Saline Flush 10 ml after each use and each lumen Q 7 days when capped. Flush with 30 ml NS after TPN and blood withdrawal. Normal Saline Flush 10 ml Q 8 Hrs when IV infusing. Normal Saline Flush 10 ml after each use and each lumen Q 30 Days when capped. Heparin (100 units/ml) 5 ml following normal saline flush after each use and each lumen Q 30 days when capped. Invasive line with flush bag and transducer. 500 ml Normal Saline. Routine flush delivered through transducer system at 3 ml/hr and PRN manual flush. Reminder: If dialysis catheter has a third smaller lumen PICC line, flush as above PICC that requires Heparin. Heparin 1,000 units/ml, equal to the interlumen volume PRN each use. Always done by Dialysis Nurses, except under special circumstances, and with specific MD order. See Dialysis Catheter Care policy.

12 Page 12 Burlew s Clues D ANIELLE S DATABASE TIPS MOBILE RESOURCES Want to search the nursing and medical lit on the go? The Burlew Medical Library provides access to several of our databases for use on mobile devices. CINAHL and Medline via EBSCO Mobile Visit: Username = burlew / password = burlew PubMed mobile site here: Visit: PubMed doesn t have an app available yet, learn more about the beta mobile For Apple users, free downloads are available from the Apps Store: EBSCOMobile app for iphone & ipod, learn more and see instructions here: Dynamed app for iphone & ipod Contact the Burlew Medical Library for more information First Consult for iphone & ipod (via MDConsult), learn more here:

13 N EW BOOK LIST Page 13 Roberts and Hedges' clinical procedures in emergency medicine [electronic resource] Hedges, Jerris R. Diagnostic and statistical manual of mental disorders : DSM-5. Umphred's neurological rehabilitation Umphred, Darcy Ann Maxillofacial reconstruction Haug, Richard H. Berry & Kohn's operating room technique Berry, Edna Cornelia. Perioperative standards and recommended practices [AORN]. PDR for nonprescription drugs. Safe patient handling and mobility : interprofessional national standards Outcome assessment in advanced practice nursing Kleinpell, Ruth M. Basics of health care performance improvement : a lean six sigma approach Lighter, Donald E. Advanced practice nursing : evolving roles for the transformation of the profession Barker, Anne M. Perianesthesia nursing : a critical care approach Drain, Cecil B. Guide to patient and family engagement in hospital quality and safety Neonatology : management, procedures, on-call problems, diseases, and drugs Cunningham, M. Douglas Daniels and Worthingham's muscle testing : techniques of manual examination and performance testing.

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