Clinical Instructor s Orientation Day August 18, 2017 AURORA
Site Specific Updates Versus Badges locaters now available on all the med surg floors 1, 2S, 2N, 3, 4, and LDRP. Request for instructor to carry spectralink was denied, but badge readers are available now. Please ask Charge RN how to add yourself to the system when you re on clinical.
Student Policy:
No nursing citations from Joint Commission visit March 2017; however we continue to monitor the following documentation closely: Pain re-assessment post PRN pain medication, within timeframe? Care plans documented Q12 hours Is I/O documented per MD order and at the correct times? Catheter Care documentation daily Restraints
Process for submitting access to training environment has changed when completing the EPIC form, use the start date for the date when you d like students to have access to the training environment. Helpdesk will assign all students an N Number to the play environment. When the student goes to clinical, the student will have their N number reactivated for the live environment Need student s email address as well on EPIC request form
Josh, IT for questions on process Handout outlining the process with helpdesk #
Use Lippincott for evidence based material, handouts for patients to provide a standardized message
Highlights:
DRESS CODE REMINDERS: Natural Hair color No artificial nails, nail polish is acceptable but must be in tact and not chipped Closed toe shoes must be worn in ANY patient care area even when on unit to gather patient assignment 1 single tattoo no larger than 2 X 2 is allowed on leg, ankle, and feet. Any tattoo that doesn t meet this criteria must be covered by clothing at all times NO body piercings except earrings may be worn. Concealing body piercings with a bandage is unacceptable.
Clinical Instructor s Orientation Day BELLIN
Room Service-Diabetic patients Real Time I&O charting- Effective June 1 st, 2017 Patient Weights-Standing weight in kg preferred IV Medications-students must have an instructor or Nurse with them to administer PIV Dwell Times- every 96 hours New Dressing change kits for PICC s and Ports
Dual sign off for High Risk Medications PT/OT- yellow ADL sheet Pharmacy Wasting- See handouts included Bellin Psychiatric Center- please contact Karen Tobin 7-10 days prior to the clinical experience
Optimizing Customer Experience Risk Based Health Care Transitions of Care Nurse Residency
A Student list and with a skills list must be posted each day that students are on the unit. The Student Skills list should include everything the students can and cannot perform.
EPIC upgrade April 2018
Pyxis Machines- see handout for quick reference guide
Refer to handout for Organizational Chart Team Leads Ali Knight, Team Leader, Kress Birthing Center Stacy Mingori, Team Leader, Surgical Services Educators Beth Watermolen, CV lab Jenny Vanderwegen, 4 Medical Ann Wanie, Surgical Services Stacy Hansen, Oconto
New Construction: Titletown Sports Medicine & Orthopedics Marinette- ASC/Rad Urgent Care ACS West Side Master Facility plan Parking: For safety student/faculty should use the skywalk from the 725 Medical building.
Bellin s Role Responsibility policy would supersede the preceptor handbook.
What do you need from us to create the optimal student experience?
The Promise Paula Hafeman welcome video Orientation and spaced learning initiative Extern program
Clinical Instructor s Orientation Day HSHS Eastern Wisconsin Division St Mary s St Clare St Vincent St Nicholas
Blood glucose meters Be sure to use CSN numbers and not MRN Core training will be in October Pyxis access Work with department leader for access Only for one area at a time Medication rooms are locked and need to have an instructor badge from the department.
Medical Emergency RRT and Codes: Within EWD we have completed multiple process improvement initiatives to ensure we have the right people in the room during a Rapid Response or a Code. During an emergency, any member of these teams may request that non team members leave the room. This needs to include the student and/or the instructor, even if it is their patient. We do support learning, but need to provide prompt, efficient care during an emergency. Evidence tells us that limiting the number of colleagues in the room helps with effective communication and work flow during an emergency. Post fall huddles After each occurrence Focus Time
How to request student access See handout Epic across HSHS Future e-learnings
Doc Halo Bed/chair alarm focus Turn off when patient is up Turn back on when patient is returned Managing alarm noise as well as fall prevention
Medication with variable dosage ranges are appropriate and allow for individual titration of medications based on an assessment of the patient. a. The absence of specific instructions in the order the nurse will adjust the medication within the dosage ranges as follows: i. Review the patient s record for prior doses and responses (including patient s verbal history of response), and administer a similar dose for similar criteria (e.g. effective dose to relieve similar pain score). If there is no record of dose administration, the nurse will use the lowest dose. If the lowest dosage is not selected for the first dose the reason for dosage selection should be documented in the medication administration comments. ii. Additional incremental doses may be given prior to the next dosing interval provided the total dose during the interval does not exceed the maximum prescribed dose and the patients clinical condition indicates (e.g. patient complains of severe pain, and has an order for acetaminophen / oxycodone 5mg 1 2 tablets every 4 hours as needed for pain, the nurse would begin with 1 tablet and may give additional 1 tablet if the patient does not achieve the desired response.) The second dose will be regarded as the dose from which the next dose will be administered. iii. When moving from IV pain control to oral pain control the nurse will use the lowest dose. Additional incremental doses may be given prior to the next dosing interval provided the total dose during the interval does not exceed the maximum prescribed dose and the patients clinical condition indicates a need for further dosing. iv. At any time the patient may request that a lower dose (provided it is in the ordered range) be administered or request a medication that is ordered for a lower pain score. Documentation of reason will be found in the comments in the MAR
SVG: Webster street Parking remains across from ramp SMG Nothing changed
Our current practice of changing peripheral intravenous catheters (PIV) every 96 hours changed on May 1, 2017. Evidence supports changing PIVs when clinically indicated instead of our current practice of changing every 96 hours. Studies have demonstrated equal complication rates with extended PIV dwell times. The benefits of allowing PIVs to remain in place until clinically indicated to change include: Increased patient satisfaction, less vessel injury, less needle sticks Decrease nursing time for restarting routine site changes Decrease costs
Professional, cover tatoos, no hoodies, name badge at chest level, hair off shoulders. Leaders doing rounding wear white lab coats to promote professionalism Have divisional teams that meet monthly to align policy and determine equipment needs
Do not congregate at the desk or in the halls Gather in designated areas Students are encouraged to engage with the nursing team when waiting for instructor Required to do bedside safety handoff Update white boards with student name Focusing on specimen labeling