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Editors: Vivian Norman, RN, MSN, CCRN Clinical Education Newsletter, March 2012 Mary Welly, RN, BC, BSN Editor’s Notes 1 Celebrating the Success of our Staff 2 E d i t o r ’s N o t e s March 2012: in this issue you will find some exciting happenings at St. Joseph Hospital: 2012 Nurse Week 3 Award Nominations March Madness: when the Nurses who make up the shared 2012 Foundation Sponsored Scholarships 4 governance councils of St. Joseph Hospital gather to share best practices, accomplishments and goals for the coming year. It is the one time each year that we re-focus our attention on our marvelous Magnet designation. This year’s March Madness will be held on March 28. Caritas Centering Exercise 5 Nurse Week: Blessing of the Hands will be held on Monday, May 7, and Clinical Narrative 6 Preventing Functional Decline While Hospitalized 7 Alaris System IUI Inspection 8 Vickie’s Research 9 Searching for Policies: Tips and Tricks 10 Policies and Procedures 11 the Nurse week reception will be on May 10. There will be more details on the flyer on page 3. Research Fair: The Nursing Research Council will hold the first “Sacred Cows: Moooving the Evidence” on May 7. Submit your clinical question in the designated boxes that will be placed on the units. We would like to encourage all of you to attend these events. It will add to the professionalism, and besides, will be fun, too! Mary & Vivian, (your professional, social planners, And newsletter editors for March) Formatting Editor: Phyllis Sharum Evidence Based Practice Seminar, October 5, 2012 NEW Skin Care Cleansers and Protectors October may seem a long way from now, but a Planning Committee is already strategizing for our 8th Annual Evidenced-Based Practice Conference! Burlews Clues 12-14 MicroBytes 15-16 Power Minute Labeling 17 This year the focus will be on the care of the geriatric patient throughout the hospital. Page 2 Celebrating the Success of our Staff Kathryn Cosgrove, Night Shift House Supervisor, graduated with her BSN from Cal State Fullerton. Cathy Shinto (CVSSU) recently received her CN III and was accepted into the MSN program at Vanguard University. Charlene Gozony, RN (Main PACU) recently received her BSN from the University of Phoenix. Hooi Teng Chen RN, CNOR from CVOR passed the perioperative nursing certification exam. Diana Quing RN, CNOR from Main OR passed the perioperative nursing certification exam Terry Roth RN, CNOR from Main OR passed the perioperative nursing certification exam Treva Thomas RN from CVOR completed the perioperative nursing 101 course Diana Perkins RN from Main OR completed the perioperative nursing 101 course Diane Upton RNC, L&D Day Clinical Coordinator, just graduated with a MSN from Phoenix University. Diane was the recipient of a full scholarship from the March of Dimes for her MSN program T hank you to all who completed the survey, “Healing Relationships Skills and Attributes Survey”! 152 surveys were completed at SJO! Two i-pods were given away for participating and the winning names were drawn during Research Council. We would like to congratulate: Esmeralda R. Delos Reyes (Rina) from General Surgery and Nic DuPree from BHS!! Rina Delos Reyes Nic DuPree Page 3 2012 Nurse Week Award Nominations H ere is your opportunity to recognize a co-worker who exemplifies excellence and quality within nursing at St. Joseph Hospital. Please take a few moments and fill out a nomination form. Anyone can nominate. Nancy Bernardino Clinical Excellence Award This award is to recognize a licensed staff nurse providing direct patient care, who exemplifies our four core values – Dignity, Excellence, Service, and Justice. Nursing Leadership Excellence Award This award was created to recognize Directors, Managers, Clinical Coordinators, Educators, Advanced Practice Nurses and extended role nurses who are excellent leaders and mentors. Nursing Assistant Award This award is intended to recognize the major contribution of our nursing assistants and patient care technicians to the overall success of patient care within our organization. Nurse Yearling Award This award honors a newly graduated nurse or a seasoned nurse who is in a new area of expertise. Nomination forms have been distributed and are available on the nursing units, in the Staffing Office, Cafeteria, and in Katie Skelton's office. Forms are also available on CareNet in the Nursing Center of Excellence. Drop boxes for completed forms are located in the SJH Cafeteria, Staffing Office, SFDB (Katie's office), Renal Center, CV-OR & Main OR Nursing Lounges, ED Nursing Lounge, Cancer Center and the Pavilion Outpatient Nursing Lounge, or the Information Booth on the 1st floor. Deadline for turning in nominations is Tuesday, March 13, 2012. Nominees and winners will be recognized during the Nurse Week Reception on Wednesday, May 9th. For any questions please call Peggy Walsh at ext. 28381. Page 4 2 0 1 2 Fo u n d a t i o n S p o n s o r e d S c h o l a r s h i p s S t. Joseph Hospital is offering six Foundation sponsored scholarships. Applications may be picked up in person from the Clinical Education Department, 2nd Floor, Sister Frances Dunn Building, beginning April 2 and must be returned by May 31. Scholarships will be awarded during July 2012. Employees who have completed one full year of employment at St. Joseph Hospital are eligible for the following scholarships: Sister Frances Dunn Scholarship Larry K. Ainsworth Leadership Scholarship This scholarship will be awarded to individuals working towards health-care or health-business related degrees, specifically those fields in which St. Joseph Hospital has a vested interest. The following two scholarships are open to both employees and non employees: Alice Paone Scholarship This scholarship provides an avenue for the proThis scholarship provides individuals with cermotion of professional advancement in nursing, tificates, degrees, or coursework leading to licen- as well as to provide a mechanism for the resure for healthcare related careers, specifically cruitment and retention of highly qualified nursthose fields in which St. Joseph Hospital has a ing staff. Recipients may be employees, volunvested interest. teers or their children. There is no assumed employment obligation attached to this scholarship Dominick Gentile Scholarship for non-employees. This scholarship provides for the promotion of professional advancement in health related areas Thomas Dorsey Scholarship for Renal Center nurses and technicians, as well This scholarship provides for the promotion of as to provide a mechanism for the retention of professional advancement for Cardiac Catheterihighly qualified staff. zation Lab nurses and technicians, as well as to provide a mechanism for the recruitment and retention of highly qualified staff. This scholarPractice RN Scholarship ship is awarded to any professional or technical This scholarship provides an avenue for the pro- cardiovascular or radiographic program that remotion of Advanced Nursing Practice, as well as sults in a degree or certificate. to provide a mechanism for the recruitment and Recipients of this award may be employees, volretention of highly qualified staff. This scholarunteers, and/or their children, or community ship is intended to support the academic members with a St. Joseph Hospital sponsor. achievement of the R.N./B.S.N. to the M.S.N. There is no assumed employment obligation atlevel. tached to this scholarship for non-employees. Madeline Colette Seeds Advanced Page 5 Caritas Centering exercise Breathing is a miracle of life. Use the time that you are washing your hands to take a few slow, deep breaths. Relax …… Calm ….. Refresh Use the time that you are washing your hands to think of not only cleansing your hands, but also cleansing your spirit, to be prepared to enter into your patient’s environment. To be the environment. Remember, what is in your heart comes out your hands. Core principles of Jean Watson’s Theory of Human Caring Practice of Loving kindness and Equanimity Authentic Presence; Enabling deep belief of others Cultivation of one’s own spiritual practice – beyond ego “Being” the caring-healing environment Allowing for Miracles Page 6 Clinical Narrative by: Salem Sweeton, RN, Clinical Nurse II, Med Pulmonary I t was my second night shift during my 10-week preceptorship. I was sitting at the nurses’ station charting when the code blue was called out. I thought to myself, “I should just continue charting; they probably have enough people already”. Then, something told me to get up and see what I could do. So, I got up and walked back to the room. I saw some faces full of panic, and then I saw the pale, blue, life -less face of an elderly woman being jostled around by each compression that the charge nurse was giving. I thought, “The charge shouldn’t be doing compression he (I’m sure) has many other things to do for this patient right now.” I put on my gloves and went into the room and took over compressions. Although I had been trained, this was only the second time doing compressions on a person’s chest. I remember looking into the woman’s face as her ribs cracked under the force of my compressions. She seemed gone. I thought, “there is no hope here, why bother” Then, I though “what if this was someone I knew or my loved one, would I just give up? So, I started to pray as I continued compressions. By this time, the whole team was there. They gave 1 mg of epinephrine and were preparing to intubate when they called for a pulse check. To my amazement, she had a strong pulse. Some time, while my hands were on her sternum cracking her ribs, her heart started to beat again. She was transferred to ICU and I don’t know how she did after that. As a new grad I learned many great lessons that night. I learned that I do have something to offer, but most of all, I learned that there is always hope. I will never forget that I had a hand in helping to bring her pulse back. It is an amazing feeling. “True success comes from knowing that you are making a difference, no matter how small, in the life of a patient, a colleague, or a student” By: Karen Baguley, MSN, RN Toronto, Ontario, Canada Page 7 SJH’s Gerontology Nursing Special Interest Group (GNSIG) each month presents EBP information to update staff and family members in providing improved care for our senior patients. “The Gero-Gem” Preventing Functional Decline While Hospitalized What is Functional Decline? Functional decline is the decrease in the ability to perform activities of daily living (ADL’s) such as walking, bathing, transferring from bed to chair, toileting, or feeding self. Functional decline leads to loss of independence and quality of life. One third to one half of all hospitalized older patients will experience some decline and is the most common complication of hospitalization. Bed rest and Functional Decline Studies show that by the second day of bed rest, muscle deconditioning begins to occur, especially in those greater than 60 years old. Leg muscles are most affected. Safely transferring from bed to chair without assistance is required to continue living independently. Maintaining the leg strength is crucial. Bed rest also leads to decrease in aerobic capacity, vasomotor instability, and respiratory function. Due to these factors, senior patients on bed rest are prone to complications such as DVT’s, falls, syncope, atelectasis, and constipation. Activities to Prevent Functional Decline While a hospital is not conducive to normal activities, try to maintain as “normal” of a lifestyle as possible. The following activities will assist to prevent functional decline. Walking at least three times a day, as long as approved by physician. Patient should ask for assistance when walking to prevent falls. Make sure patient has slip resistant socks or shoes on. If unable to get out of bed, request physical therapy and encourage simple bed exercises. Encourage patient to wear glasses and hearing aids and keep available at bedside. Keep assistive devices that patient uses available at bedside (cane, walker). Assist patient to get out of bed for all meals. Not only will this help keep moving, but it will also assist with digestion and lung function. Encourage/offer patient to toilet every two hours while awake. Encourage use of bathroom or bedside commode instead of bedpan. Have patient sit at the sink to bathe or shower if this is their normal routine. Have patient brush their teeth and hair while up and assist changing gowns. These are good arm activities. Keep mind active with music, newspapers, puzzles, phone calls, and TV. REMIND PATIENT TO BE SAFE AND NOT GET UP ALONE REFERENCE: King, B. (2006). Functional decline in hospitalized elders. MEDSURG Nursing, 15(5), 265-272. Page 8 PRIOR to attaching the Alaris Module to the Main Brain INSPECT for Cracks Rationale: the unit will does not function properly Page 9 Welcome to Vickie’s Research Corner Research Fair Here we are in 2012 and the Nursing Research Department and Council has been very busy planning another wonderful year! We have planned a wonderful Nursing Research Fair on May 7th, 2012 during Nurses Week; so please SAVE THE DATE!! The concept of the research fair came from our own Beth Winokur after going to a Magnet Conference and seeing another hospital present their research fair. She brought the idea to the research council and here we are planning away! The fair will be located in the staff entry-way to Building Two. The theme is Sacred Cows! Moooving the Evidence! Sacred Cows are “traditional practices that are routinely carried out but may not be justified as best practices to achieve optimal patient outcomes” (Mick, 2011). Examples include the Cash Cow- this is the most expensive but cost-ineffective traditional practice being performed without supporting evidence; the Mad Cow- this is the craziest, most bizarre, outlandish, weird, and ridiculous traditional practice being performed Without evidence; I never saw a purple cow- no one has ever read any evidence that supports this traditional practice or can explain why it is being done; “Til the cow comes home”- a traditional practice of unknown origin being performed for the greatest number of years without supporting evidence; Don’t have a cow- everyone would be upset to give up this traditional practice, even though there is no evidence for doing it; and put the cow out to pasture- everyone is aware there are no benefits to this practice and would like to get rid of it! (Mick, 2011). Watch for Nursing Research Council members coming to your unit to present and look for the Great Cookie Experiment over the next month. AND……… put on your overalls and come to the farm to see how all the sacred cows impact your practice. We will also be running a contest soliciting Clinical Practice Questions throughout the next several months that will continue through the day of the fair! Each unit will have their own cow box to place a Clinical Practice Question in and hopefully be selected as the winner – if you win you get to go to the Magnet Conference in October which is in Los Angeles this year. This is a great opportunity for a staff nurse to go to this conference! All nurses are encouraged to submit a clinical practice question. Page 10 Searching for a Policy? Page 11 New Skin Care-Cleansers and Protectants Remedy Z-Guard Skin Protectant Remedy Antimicrobial Remedy Clear-Aid Skin Protec- Remedy Antifungal Clear Oint- Remedy Dimethicone Skin Protec- Page 12 Burlew’s Clues By: Danielle Linden Keep up with the latest evidence We realize how difficult it can be for RNs to keep up with the professional literature, but with the push toward Evidence Based Practice keeping up with the evidence is more important than ever. Let the folks at Burlew Medical Library help keep you up to date on new articles published in your fields of interest. We subscribe to 100’s of nursing journals in electronic format and can set you up to receive automatic Table of Content (TOC) notification emails when new journal issues are released. For instance, if you work in the Infusion Center, we can set you up to receive a monthly email with the list of new articles published in the latest issue of Journal of Infusion Nursing. You will have the ability to access any of the articles online through the Burlew Medical Library – or you can request the articles directly from us. The following is an abbreviated list of journals that we can set you up to receive TOC emails for – the full list of journals is available on our A-Z Online Journal List at www.BurlewMedicalLibrary.org: AACN Advanced Critical Care Advances in Skin & Wound Care AJN, American Journal of Nursing AORN Journal Cancer Nursing Dimensions of Critical Care Nursing Holistic Nursing Practice Journal of Cardiovascular Nursing Journal of Emergency Nursing Journal of Patient Safety MEDSURG Nursing AND MORE!!! Contact Danielle Linden at ext 17759 or [email protected] for more information Nurses earn FREE CEUs from CINAHL through the Burlew Medical LIbrary Visit http://ceu.cinahl.com/ Under the “New User Enrollment” section, choose “Click here for pre-registration” Fill out the form and click “register” (remember to write down your password!) Once you register you will be sent an “unlock” code and further instructions for confirming your account to the email you provided in the registration form. Check your spam or junk mail file if you do not receive this email within 10 minutes After confirming your account you will be logged in to the home page. Click on the “available modules” tab for a list of classes. Before taking your first test you will be asked to fill out a form with your professional information and hospital affiliation. Please use the hospital’s address, 1100 W. Stewart Dr. Orange, CA 92863 Please see the FAQs for more information or contact CINAHL at [email protected] or 800-959-7167 Page 13 New Book List Alexander's surgical procedures Alexander, Edythe Louise; Rothrock, Jane C.; Alexander, Sherri M. Basic arrhythmias Walraven, Gail Basic concepts of psychiatric-mental health nursing Shives, Louise Rebraca Cancer nursing: principles and practice Yarbro, Connie Henke; Wujcik, Debra; Gobel, Barbara Holmes Caring for older adults holistically Anderson, Mary Ann Change leadership in nursing: how change occurs in a complex hospital system Hickey, Mairead; Kritek, Phyllis Beck Clinical decision making: case studies in medical-surgical nursing Ankner, Gina M. Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk. Briggs, Gerald G.; Freeman, Roger K.; Yaffe, Sumner J. Electronic health records and nursing Gartee, Richard; Beal, Sharyl Essentials of e-learning for nurse educators Bristol, Tim J.; Zerwekh, JoAnn Essentials of fetal monitoring Murray, Michelle L.; Huelsmann, Gayle; Koperski, Nanci Gerontological nursing: Scope and standards of American Nurses' Association. Grief, loss and bereavement: evidence and practice for health and social care practitioners Wimpenny, Peter; Costello, John Francis Human caring science: a theory of nursing Watson, Jean Intravenous medications: a handbook for nurses and health professionals Gahart, Betty L.; Nazareno, Adrienne R. Page 14 New Book List, con’t Manual of neonatal care Cloherty, John P. Manual of perioperative care in adult cardiac surgery Bojar, Robert M. Measuring caring : international research on caritas as healing Nelson, John; Watson, Jean. Pediatric nursing procedures Bowden, Vicky R.; Greenberg, Cindy Smith Pharmacology and the nursing process Lilley, Linda Lane, et al. Primary care : the art and science of advanced practice nursing Dunphy, Lynne M. Hektor. Psychiatric mental health nursing : concepts of care in evidence-based practice Townsend, Mary C. Review of hemodialysis for nurses and dialysis personnel Kallenbach, Judith Z. Shared governance: a practical approach to transform professional nursing practice Swihart, Diana. Transcultural concepts in nursing care Andrews, Margaret M.; Boyle, Joyceen S. Your first year as a nurse: making the transition from total novice to successful professional Cardillo, Donna Wilk Page 15 How to register for classes on HealthStream ● MicroBytes by: Phyllis www.healthstream.com/hlc/sjhsca ● Once you login to HealthStream, enter your User ID (your 6 digit employee number) and the password: comply (lower case) Enter the website address: Go to CareNet, look for the HealthStream logo on the home page: 1. Click on the Catalog Tab. 2. Either search by Category or type the course your looking for in the search field. 3. Click on the Course you are searching for and it will take you to the Curriculum Overview. Click on Enroll 4. Click on the link Course Information to review the class details. Then click on Enroll. The Course Details window will open. You are not registered yet. Click on the link to the learning activity and click on Register. You will see confirmation of class registration. Page 16 Computer Classes for April, May, June, 2012 All classes are held in Computer Room 6B using Office 2007 April May June Access: Introduction April 19; 8:30-12 Queries May 17; 8:30-12 Forms and Reports June 13; 8:30-12 Excel: Introduction Intermediate April 16; 8:30-12 June 4; 8:30-12 May 7; 8:30-12 Pivot Tables May 30; 9-12 Excel Visual Basic Applications (for Advanced Users only!) May 2; 8:30-12 Part 1 of 2 June 6; 8:30-12 Part 2 of 2 PowerPoint Introduction May 10; 8:30-12 Creating Powerful Presentations June 21; 8:30-12 Word Introduction April 24; 8:30-12 Intermediate May 16; 8:30-12 Outlook April 27; 1-3pm Publisher April 23; 9-12 Please contact Phyllis Sharum, x17435, for any questions regarding the Classes. [email protected] June 25; 9-11am Page 17 Please Read IV Lines & Intravenous Medications that Require a Label Please Label: Multiple medications infusing into one IV site Please Label: Continuous medication infusions, regardless if only one medication per IV site What type of label do I use? A white label is preferred (exception: unless a pre-printed label is used, such as in critical care settings) What do I write on the label? Print clearly, the name of the medication infusing When do I label the line? The IV line will be labeled at the time of connection Where do I place the label? The label is to be placed at the end of the tubing, closest to the insertion site [i.e. insertion into the primary line, directly into the IV site] Please label… Tubing’s/Catheters Infusing Medications other than peripheral intravenous routes: Epidural Medications or Femoral Nerve Blocks are to be labeled at the time of connection, closest to the insertion site Central Venous Catheters, Hemodialysis Catheters, and Peritoneal Dialysis Catheters are to be labeled with the clearly printed name of the catheter whether or not medications are currently infusing Reference: RX-444 Medication / IV Administration, page 12 of 15 Power Minute sent on 06.28.11 by Tina Retrosi, Patient Safety Officer Power Minute re-sent on 10.11.11 by Tina Retrosi, Patient Safety Officer