Nursing Kronicle January/February 2018

Kenmore Mercy Hospital

Kronicle

News and announcements for Nursing Staff at Kenmore Mercy Hospital January/February 2018

Successful Joint Commission Survey Completed Winter is here!

Along with this particular winter came cold weather, tricky driving, flu, colds and many very ill patients.

In addition, this January we had visitors from The Joint Commission who provided us a thorough and helpful survey.

All and all, it has been a very challenging few months for everyone who provides direct patient care.

I want to thank all of you who have picked up extra shifts, those who stayed over to help your colleagues, and those that floated to other units to help out.

Your efforts have not gone unnoticed, Kenmore Mercy Hospital’s Administration and nursing leadership are very grateful to you for your commitment to our patients and each other.

We are now in the process of hiring ahead, meaning filling additional positions in preparation for any turnover.

We are also able to bring on agency to Kenmore Mercy Hospital. Prior to February we were having a difficult time in obtaining agency nurses. We are grateful to them as well for helping us out.

Thank you also for your efforts in the Joint Commission survey, the surveyors were very impressed with your knowledge and your dedication to your work. Nursing did very well with this survey!

Wishing all of you a healthy and very happy year ahead. Spring is coming!

This past January, Kenmore Mercy Hospital completed a four-day survey with The Joint Commission, resulting in full accreditation.

This was the first acute care survey in Catholic Health during which The Joint Commission utilized its new survey methodology known as the SAFER Matrix.

The new system classifies how widespread an issue is throughout the hospital and also indicates the likelihood that the issue could cause harm to a patient, visitor or staff member.

Under this new system, Kenmore Mercy had no citations that were considered widespread throughout the hospital or with a high likelihood of patient harm.

“This is a great accomplishment. Thanks to everyone who participated in preparing for this event,” said Walt Ludwig, hospital president & CEO. In their exit interview with the hospital’s leadership team, the surveyors often mentioned how impressed they were with the associates and physicians they met.

They noted how well prepared everyone was for this survey and could sense a great team spirit and engagement with our associates.

Congratulations to all of you on a job well done!

Congratulations!

Redesigned Nursing Peer Review Up and Running

Our Operating Room staff has proudly worked 100 days without an associate related injury!

The redesigned Nursing Peer Review is up and running at Kenmore Mercy.

After reviewing recent cases, here are some key areas we would like to highlight for further improvement and education: n Critical Values Notification and Documentation

Joy MacNeil-Ennis, BSN, RN, from the 2 West Patient Care Unit, is now the Stroke-Certified Registered Nurse (SCRN).

Kayla Hoffman, BSN, RN, from the 2 West Patient Care Unit, passed the Certified MedicalSurgical Registered Nurse (CMSRN) boards.

Joy

Heather Telford, MS, RN, CEN, director of Nursing, received her Nurse Executive AdvancedBoard Certified (NEA-BC). This validates her clinical knowledge and skills as a nurse leader.

The “Go Red for Woman Awareness Day” was held in February $218 was raised for Helping Hands. A special thank you to the nurses in Cardiology and 3 East, as well as Sue McClure and Julie Marshall for their help.

• The RN is responsible for reporting critical results to a provider within 60 minutes from the time the result is obtained.

• The RN will document in the Critical Values Notification from the filtered list:

- date and time of all calls placed to the provider - time the call was returned - critical value given to the provider - actions requested by the provider • Please refer to the policy CHS-QPS-016 for a complete list of tests and results that are considered critical.

n Skin and Wound Assessments • The Braden Scale should be completed within four hours of admission to med/surg units, two hours of admit to ICU/CCU and then daily in acute care settings.

Hoffman

- Implement prevention measures according to Braden Score.

• A skin inspection needs to be completed at minimum of every shift.

Any of the following findings needs to be documented:

- Reddened areas, scars, rashes, ecchymosis, incisions, pressure injuries, leg ulcers, diabetic foot ulcers, lacerations, burns, graft donor sites and excoriations.

n Medical Restraints

Welcome To Our New Hires Since December Kyle Armstrong, NA - 3 East Megan Bolton, RN - 2 West Shannon Donovan, RN - 3 East Marielle Gaglione, NA - 2 West Cally Hess, NA - 3 East Amber Mack, RN - ICU Christine Rizzo, RN - ICU Ashley Thomas, RN - ICU Jessie Valdez, NA - Float Marisa Walck, RN - 2 East/2 South Abbe Walsh, RN - 2 West Eunice Wiredu, RN - 2 West

Nursing Tips • Always check written physicians orders • Nurses should always check and acknowledge orders put in by the unit clerk • If physician doesn’t answer Tiger Text in timely manner (policy is 30 minutes) take the next step…call

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• Orders for restraints must contain the following elements:

- Date and time - Type of restraint to be used - Duration (time limit) for behavioral restraint - If verbal order, signature of RN writing order - Provider signature • Discontinuing restraints:

- Medical/surgical restraints should be continually assessed for opportunity for removal and be discontinued at the earliest possible time regardless of how long they are ordered for.

- Discontinue restraints when clinical treatment is discontinued (lines removed, extubated, etc.) or when patient’s actions no longer warrant restraints.

- The RN caring for the patient may discontinue the restraints based on assessment of the patient.

- When discontinuing restraints, the RN needs to document why the restraints were discontinued on the Restraints Assessment and discontinue the order in Soarian. The RN should also notify the provider of discontinuation within the next time frame that an order would be needed • Documentation of restraint assessment needs to be done at least every four hours • If the restraint is removed in an attempt to assess the patient’s ability to remain restraint free and reapplication is necessary, a new order is needed to reapply the restraints.

• Restraints that are removed due to patient being accompanied by family or visitor will require a new order if restraints are reapplied.

• Restraints may only be removed and reapplied without a new order when the removal is needed to provide care and the patient is under supervision.

Patient Discharge Folders Rolled Out On All Units

Pyxis Upgrade is Here

On January 31 each inpatient unit began providing patients with customized Kenmore Mercy discharge folders to organize all of the documents they receive during their hospital stay.

The need for a discharge folder was identified by a clinical nurse participating in the Nursing Research Committee.

Nursing leadership and the Shared Governance clinical nurses collaborated to design the discharge folder to assure that it will meet the needs of our patients.

Joy MacNeil-Ennis, RN Each patient receives a folder upon admission for the clinical team to use for organizing patient documents throughout their hospital stay. The folder containing the paperwork will then go home with the patient.

The discharge folders were piloted on 2 West in April 2017. Once the decision was made to make this a hospital-wide initiative, the 2 West clinical nurses were surveyed in order to get their feedback on the design of the folders and submit any changes they felt would improve them. The feedback from the 2 west clinical nurses was used in combination of feedback from the leadership for the final product.

Patient satisfaction scores will be tracked to see if the folders have a positive effect for the questions: “During this hospital stay, did you get information in writing about what symptoms or health problems to look out for after you left the hospital?,” and “When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.”

Jacket Sale This March Friday, March 9 from noon - 4 p.m.

Thursday, March 15 from 6:30 a.m. - 10:30 a.m. first floor Associate Entrance - rear of hospital Two styles available!

Sport-Tek® Ladies and Mens Sport-Wick® Full-Zip Jacket A portion of sales benefit the Kenmore Mercy Foundation

Ladies Zip Front Warm-Up Jacket

Try on. Pay by check or credit card.

Or visit the online store.

Embroidery options available.

Samantha Kulu, RN From February 12 - 22, a new enhanced Pyxis Operating System was deployed to all of the clinical areas.

The screen will have a very different look but more importantly, the functionality will allow for more efficient and safe medication dispensing-related decisions.

There are approximately ten Net Learnings, two to four minutes each that are required by all nurses who use the Pyxis system.

Use the term “Pyxis medstation” to search the CBLs for the following titles: Pyxis Medstation ES System Clinician Workflows - Quiz Pyxis Medstation ES System Station Tutorial Assessment for Nursing Pyxis Medstation ES Remove Medications from a Profile Station Pyxis Medstation ES Document Medication Waste Pyxis Medstation ED Remove Medications from a Non Profile Station Pyxis Medstation ES Search for and Select Patients Pyxis Medstation ES Return a Medications Pyxis Medstation ES Resolve A Discrepancy Pyxis Medstation ES Perform Inventory Pyxis Medstation ES Recover a Failed Storage Space Pyxis ES Basics Nursing Requirements: • The Assessment for Nursing is a NetLearning quiz that requires an 80% pass rate in order to be competent for the new system.

• Each nurse will have to be Bio-ID for the new operating system • There will be peer superusers (and of course your nurse manager) on each unit trained to assist with the Bio-ID process and answer questions.

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Magnet Projects and Goals for 2018 1. Evaluate hush curtains for the ED triage area 2. Enhance Patient education: - Evaluate patient self-management educational tool kit (APP) - Use baseline questionnaire to for educating on side effects.

3. Lean in the OR: Cart mapping.

4. Nursing staff education: Education vs. compliance - Capture staff interest to increase what they read and retain, - Use pictures of babies, puppies to advertise need to know information.

5. Professional boards on each unit: - Divided sections for CAUTI, PI, days without falls projects, SG minutes, research etc.

6. Enhance comfort care/ Palliative care measures: - Staff comfort bag-candy, prayer cards for staff - Huddle/comfort moment/huddle with patient and family.

- Comfort care cart for family.

7. Implement MEWS to identify early changes in medical status.

8. Increase and promote community involvement of the nurses.

9. Education, food bank, city mission, increase access to homeless, community health needs (opioid, homeless, seniors), Cornerstone.

10. Reduce and effectively handle violence in the workplace: - Interprofessional education and collaboration - Behavior alert response 11. Reduce falls: - Zip lock bag for bundle, education pamphlet for family, housekeeping participation, interprofession assistance.

12. Enhance nursing staff understanding of the budget process, enhance input into the budget process, understand insurance payments 13. Manager round once a month on nights 14. Peer review: Each nurse reviews every other nurse, keep anonymous. Safety issue goes to other peer.

15. Staffing toward geographical area (2E) 16. Effective and timely report and hand off.

17. Magnet document on I Cloud – share input for document 18. Poster presentation during nurses week: each unit will submit a poster.

19. Enhance research: 5 studies per year

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LOVE Award 2017 Lunch for Winners and Nominees