ER ORIENTATION OUTLINE DAY 1

Transcription

1 ER ORIENTATION OUTLINE Index: Addendum: #7 DAY 1 1. Introduction to staff a) RN s b) LPN s 2. Lounge a) Bathroom b) Lockers Coat hang area - Purse - Coffee - Refrigerator - (FYI) Board c) Reference Books 1) Environmental Safety White/Orange 2) Administrative Policy White/Pink 3) Nursing Standards Black 4) Unit specific ER Dark Blue 5) Infection Control Green 6) Marquette Reference Books White 7) Pharmacy Green 8) Regulations for Administration of IV meds 9) Teaching tools Book 10) PDR 11) Formulary 12) Time Book 13) Information Update 3. Time and Attendance a) Shift times Clocking in and out Requests book - (AL, Sick, No Lunch) Switch Slips Double Shifts Calling in On call/call back Codes for Doors Breaks/lunch

2 Page 2 of Dress Code a) RN/LPN 5. PYXIS 1) Access Pyxis 2) How to obtain meds 3) Return meds 4) Waste of narcotics 5) Stock supplies H 2 O 2 Betadine 6) Narcotic count Wednesday 6. ER Supplies a) Charging out items with stickers and how to charge without stickers b) Obtaining supplies from stockroom c) Obtaining supplies from CSR d) Stockroom e) Orthopedic Cabinet f) Trauma Cabinets g) Order Book 7. Monitors a) Marquette 1) Paper replacement 2) Set up b) Life Pack 10 1) Batteries discharging, replacing 2) Transport 3) Paper c) Physio Control 8 1) Paper d) Pacers 1) cables 2) pads 3) cart e) Tele packs

3 Page 3 of Trays a) Suturing Route 1) Set up 2) MD-personal preference 3) Break down 4) Suture removal 5) Sharps b) I&D c) Plastic trays 1) Standard 2) Personal physician d) IV Tray 1) Blood draws A. Tube colors B. Labeling 2) Blood Bank A. Signature List 9. Respiratory a) Pulse ox b) O 2 1) Nasal 2) Mask 100% 3) Vents c) Aerosol mask 10. ER Charts a) Triage 1) Standing Orders a) Chest Pain b) X-rays c) Tylenol Advil d) Kidney Stone b) Assessment c) Nurses Notes d) Obtaining patients old chart e) Referrals to appropriate discipline f) Clinical Guidelines g) Patient/family teaching

4 Page 4 of Nurse s Station a) Telephone 1) Answering pone unit, name and title 2) Transferring calls 3) Wall phones separate numbers 4) Hold 5) Location of beeper list a) Ho to page a beeper 6) Leaving message on voice mail 7) In-house dept list 8) Doctors list 9) Employee list b) Drawer supplies c) Computer 1) ER Ordering d) Others Supplies 1) Accuchek 2) IV Chart e) How to charge out supplies used including medications 12. Special Procedures a) Consents 13. GYN a) Room b) Set up special needs of physicians c) Cultures 14. A. Crash Cart a) Check crash cart b) Go over monitor 1) Defibrillation How to check plugged and unplugged 2) Synchronous cardioversion 3) External pacing c) Red Tags how to obtain from pyxis d) Code sheet e) Full cart check Wednesdays f) Code response in hours Dr. Heartwell B. Pediatric Code Cart

5 Page 5 of Rooms a) Stretchers b) Code Button c) Suction d) Cabinets Stock e) Wall 1) O 2 outlet flow meters 2) Suction suction heads Canisters f) Monitor 1) Admit/discharge patient 2) O 2 Sat. 3) B.P. 4) Plugging in cables 5) Graphing patient g) Call Buttons 16. Scavenger Hunt 17. Safety a) Dr. Firestone 1) RACE 2) Personal role b) Dr. Dee Their role c) Dr. Heartwell 1) Their role 2) Number to dial d) Dr. Strong 1) Number to dial e) Dr. Spock 1) Role 2) Number to dial f) Restraint leather & soft 1) Policy 2) Flowsheet g) Bed safety 1) 2 side rails up on all patients 2) Bed in position, locked 18. Harvard Pump a) Set up b) Key location

6 Page 6 of Abbott Pump a) Primary b) Secondary c) Blood Transfusion Review the day 1. Employee Development Plan 2. Skills list 3. Problem/concerns 4. Achievements 5. Goals Revise Plan

7 Page 7 of Rhythm Test DAY 2 2. Lifepaks a) Cardioversion 1) Elective Conscious Sedation Policy Respiratory Anesthesia 2) Non-elective 3) Reasons for Cardioversion b) Defibrillation 1) Explain procedure c) External Pacer 1) Indications for use 2) Pad Placement 3) How to set up on: Lifepak 9 Lifepak Temp. Pacemakers a) Set up insertion of consent b) Anatomy c) Pacer box 4. Thoracentesis a) Set up consent b) Explain procedure c) Chest tubes 1) Thoraseal 2) Care of 3) Assessment of patient with chest tubes 5. Trach a) Care of patient 6. Orthopedic a) Jones dressing b) Ace c) Air cast d) Crutches with walking instructions 7. ENT Tray a) Set up 8. Eye Tray a) Morgan lens

8 Page 8 of 10 ER SCAVENGER HUNT 1. Air Cast 2. U. Bags 3. Spinal Tap Tray 4. Anal Scope 5. Spinal needles 6. Specimen hats 7. Peri pads 8. Clothing bags 9. Triple luman kits 10. Policy & Procedure Book Find page number of policy for pregnant patient in ER 11. DNR form 12. Where do we get the latex free cart? 13. Peak flow 14. Papoose 15. Small retractor 16. Policy on patient requested blood ETOH 17. Soft restraints - leather

9 Page 9 of 10 DAY 3 1. Clinical Paths Fractured Hip Pneumonia Heparin TPA Retavase MI CCU 2. Admit Days Evenings Admit to unit 3. Transfer a. To floor 1) notify departments 2) get chart together 3) admission papers b. Out of Hospital 1) Forms 2) Transfer Consent 3) Cobra Form 4) Securing beds 5) Calling squad/helicopter (include security) 6) Copy chart 7) Copy x-ray 8) Call hospital patient is transferring to and give nurse to nurse report c. Log Book d. Morgue Pack 1) Paper Work 2) Sharing Network 3) Transport to morgue e. AMA

10 Page 10 of 10 DAY 4 ROOM ASSIGNMENTS , 1-2 Triage