Administrative Supervisor Meeting August 13, 2013 MHE Stoltz Room, 2 nd Floor 08:30 10:30 Presiding:, MSN, RN, NEA-BC Present: Kate Norton, RN; Dottie Waters, RN; Gwen Lee, RN; Deb Pumphrey, RN; Jeanne Lusby, RN; Patty Ferguson, RN; Annie Kusinitz, RN; Trish Ebner, RN; Cheryl Hazeltine, RN; Linda Libby, RN Excused: Deb Pumphrey, RN Minute Approval and Followup Items Consent Agenda The minutes were approved with date of the meeting corrected. Dottie Waters questioned the following policies: EC-33: Personal Electronic Appliances: 2.0: Prohibited Equipment 2.4: Cellular Phones EC-57: Access Control in Sensitive Areas (Pharmacy) 5.0: For emergency medications needed from the Pharmacy after routine business hours: 5.1: Only the competent Administrative Supervisor may enter the Pharmacy 5.2: The Administrative Supervisor shall enter the Pharmacy alone Follow-up with Gary Poole Delete the word competent. Follow-up with Susan Siford regarding 5.1 and 5.2. 1
Acute Care Meeting Discussion was held regarding the combining of the Administrative Supervisor Meeting and the Acute Care Meeting. stated that she attended the Acute Care Meeting last month to discuss the combining of the two meetings and they felt it was a great opportunity. A joint meeting will help build trust and foster efficient communication. Diane stated encouraged the supervisor to attend the meeting in person. All meetings will be held at MHE on the first Thursday of each month from 8:30 10:30. The meeting dates are as follows: Combine the Acute Care Meeting and Administrative Supervisor Meetings for a trail period of September thru December and reevaluate. If issues need to be handled outside the monthly meeting, an ad hoc meeting will be held. Group September 5, October 3, November 7 and December 5. CPOE/IV Spreadsheet Training Jeanne Lusby stated she felt that having a quarterly meeting was sufficient. Annie Kusinitz, Dottie Waters, and Kate Norton felt it is a good idea, however, the group felt there may be the need to have a quarterly supervisor meeting to discuss issues the maintain only to them such as scheduling. Jo Anne Thomson attended the meeting as a guest to discuss CPOE/IV Spreadsheet Training. CPOE will not impact the nursing department too much. Current, physicians are using paper for Orders. This will change to be an electronic mechanism for Physician Order Entry. Once a physician has entered an order, the nurse will acknowledge the order. For one month we will acknowledge the order on paper and in the computer. Classroom training will be held during the month of September. Online training is available on HealthStream. Watch the video online via HealthStream which is available now. There is no training needed for the IV Spreadsheet. Because the course is not mandated, Jo Anne will send the name of course so that the Supervisors can access. Group Jo Anne Thomson Transition in Care Cab Gwen Lee provided information to regarding cabs/taxis. Follow-up with Terri Ross Cabs rarely run after 2200-2300 on the weekends. There are also no guidelines as to how much and/or how we are authorized to pay 2
for a cab ride. Patients left in the waiting room are offered a pillow, blanket and food. They are not simply left on their own. They are also provided with MUST bus scheduling information. It is Gwen s experience that once a patient has stayed in the waiting room for about an hour, they miraculously find a ride home. This program does not work in its current state. a. There is no reliable cab service in either Easton or Cambridge. b. There is no tracking mechanism to identify and eliminate abuse of the system. c. There are no guidelines for how far/how much a supervisor is authorized to pay for cab services. d. No two supervisors are doing the same thing. e. Case management has been problematic demanding that people be transported and charging up the $80 for cab ride. Only a supervisor or manager can approve. f. QAEC calls Easton and wants the supervisor to provide cab vouchers rather than doing their own. Gwen offered the following suggestions: a. Set a limit on the number of cab vouchers any individual may use in a 12-month period. b. Enter all cab voucher information into the S drive so every supervisor can quickly check the information. c. Set a limit for a dollar amount/mileage that a voucher can be offered. d. Enter into agreements with local cab companies that will agree to provide services 24-hours, pay them regularly, maybe at a higher rate, they will be willing to increase their availability. e. Stop case management from offering vouchers. Everything must come through the supervisors. f. Develop a routine for those who cannot be offered 3
vouchers. DGH Pharmacy Discussion was held and it was felt that case management should assume more responsibility for vouchers. Jeanne Lusby discussed an issue where UMSMC @ Dorchester ED asked her to take custody of home medications from a patient that was being admitted. There were a total of 32 pill bottles and also OTC medications on blister-pack cards. These were all in a big bag with the medication list stapled to the outside of the bag. Jeanne called the pharmacy at UMSMC @ Easton and was first told the meds could go in an empty Pyxis drawer. When she explained the number of bottles she had, she was told to keep the bag of medications in the Supervisors office. Jeanne stated she can secure the office during her shift because she carries the office keys with her as do the other supervisors during non-business office hours. Jeanne asked what happens to the security of these medications during the weekday hours when this office is open. There is no locked cabinet/box in the supervisor s office for this purpose. Security informed Jeanne that they are not allowed to take the medications into their custody. Also, if the patient is discharged when a supervisor is not working, they do not have access to get the medications back. This issue was forwarded to Susan Siford and Ruth Thompson. They are looking to see what else they can do. i.e., getting a double lock system. stated that we need to encourage the family to take all medications home. Pediatrics Jeanne asked why Cheryl Wanex cannot carry a Spectralink. Jeanne has been told by Cheryl that per management in pharmacy, she cannot carry one because she ends her day at UMSMC @ Dorchester and would have to take the phone home with her. Discussion was held regarding staffing on Pediatrics. If they have four or less patients, they do not use a sec/tech. No one has heard this information. Follow-up with Susan Siford regarding Spectralink for pharmacy tech. Follow-up with Patty MacDougall 4
AMA Patients Roundtable Jeanne Lusby stated that Security would like to be notified when a patient is leaving AMA so they can escort the patient out of the hospital. Dottie Waters: Kate deserves a gold star to deal with the trials and tribulations with no staffing. New Administrative Supervisors Magnet/Falls Linda Libby: Dietary at UM Shore Medical Center @ Dorchester is still having issues. o All the refrigerator doors are locked and there is supposed to be a key which there is not. o Dottie Waters concurred and stated the food quality is awful. o There is an issue of having to go from floor to floor to look for food. Janet Wilson and Grace Gonzalez have accepted the Administrative Supervisor positions. Grace will start on September 7 and Janet will start on September 15. Gwen Lee will start next week during the day. Dorchester 2East needs assistance in fall prevention. A strong action plan has been developed. The supervisors at DGH have a role in this plan. Please conduct a review of the patient record for all admissions to DGH 2E. Review includes the database physical assessment, admission and shift fall risk score from the Hendrich s screening tool, medications and the fall prevention plan. Assist staff in recognition of physiologic indicators that place pts at risk (coarse breath sounds, wheezing, on oxygen, gait issues, balance issues, visual issues, etc) If the patient fall plan needs to be adjusted based on your review of the record, engage the nurse on DGH 2E and explain your findings and adjustment needed to fall prevention plan. Keep a log of issues so they can be tracked. If consistent issues, send to and she will follow-up with Keith Gould. All All 5
Next Meeting The meetings will be discontinued as the combined Acute Care/Supervisor meeting will be held Sept-December 2013 at which time the combining of the meetings will be evaluated. 6