Download Washington County Hospital Guide

Hospital Clinical Site Guide
Hospital
Pharmacy
Lab
Dietary
Respiratory therapy
Code for both med carts
Vital signs
ACCU checks
Parking
Employee entrance
Medication passes
Tubing changes, IV fluids
HIPAA
Before procedures
Insulin, heparin
Datascope (automatic BP)
Patient charge stickers
Burgundy charts (nurses station)
Green chart (nurses station)
Treatment book (nurses station)
MAR (MAR room)
Charting:
Assessment:
Vital signs:
FSBS:
Medications:
PRN pain medications:
Treatments:
8-12-16
0630, 1130
Turn to left, far end of back parking lot by doctor's offices.
Use emergency room entrance at back of hospital, as front door will be locked.
30 minute window (before and after); PRN evaluation: 1 hr. Some medications
are kept in the medication refrigerator in the medication room. IV antibiotics and
IV fluids are in the medication room. CHECK AND HAVE ALL OF YOUR
MEDICATIONS READY BEFORE MED PASS TIME. Will need to ID patient
by name, date of birth, and medical record number.
Q72 for regular IV line; Q24 for antibiotic piggybacks; Q24 IV bags
No names on doors/ charts, MARS kept on top of med carts in MAR room
Check policy and procedure and Lippincott Procedure Manual
Need TWO licensed nurses to check before giving
Only 2 units, situated in front of nurse's station (also portable monitors in rooms ----). BRING YOUR OWN MANUAL BLOOD PRESSURE CUFF.
YELLOW sheet in MAR (blue stickersIV starts, tubing); WHITE sheets
(white charge sticker book) in clean utility room across from 102 (yellow
stickers)
Nurse's progress notes (2 pages), interdisciplinary care plan, interdisciplinary
care plan documentation record, skin assessment for decubiti, frequent vital sign
and general flow sheet (I & O, BM's, turning), patient teaching documentation
(diabetic teaching sheet, multidisciplinary education documentation, clinical
services patient education)
Vital signs graphic chart, diabetic flow chart, patient admission assessment (2
pages--good source of information on your patient), documentation of advance
directive intent, physician's orders, pain management education form,
immunization flow sheet form (2 pages), discharge planning form
Treatment record forms (IV site care, Foley care, OOB in chair, diet, bleeding
precautions, labs, one-time orders, I & O, 02 @ 2 L, daily weight, VS q4 and
pulse ox)Takes the place of the KARDEX
Medication administration record, pain flow sheet, yellow charge card (blue
stickers only)
Beginning narrative note on both nurse's progress notes AND interdisciplinary care plan
documentation record. Narrative note Q2º in nurse's progress notes. Head-to-toe
assessment on nurse's progress notes.
Frequent vital sign and general flow sheet (burgundy chart), vital signs graphic chart
(green chart)
MAR, nurse's progress notes ("FSBS 264 by #1 machine" [burgundy chart]), diabetic
flow sheet (in front of green chart)
MAR (1st line description of medication; 2nd line actual dose to be given and amount)
MAR, pain flow sheet; nurse's progress notes (when given, evaluation within 1 hour)
(burgundy).
Near the end of student nurse shift, check off all that apply on treatment record form
(treatment chart)
Floor map:
Nurses station
Medication room (across from nurses station)
Soiled utility (across from room....)
Clean utility (across from room...)
Storage (across from room...)
Rooms ---------Break room (across from room....)
Student conference room (room...)
Equipment room (across from room...)
Employee bathroom (across from room...)
Soiled utility (across from room...)
Clean utility (across from room...)
Tub room (across from room...)
Tub room (across from room...)
Nourishment room (across from room...)
Organization:
0630
0700-0730
0730-0800
0800
0830
0900
1000
1100
1130
1130-1230
Charts, policy and procedure, Lippincott Procedure Manual, code cart,
telemetry monitoring, Tympanic thermometers, Datascope
IV supplies (#24-#18, saline lock kits, tourniquets, arm boards), IV
tubing for both primary and secondary, bags of IV fluids, NS flushes,
syringes of various types (insulin syringes), alcohol pads, sterile gauzes,
antibiotics, refrigerator for medications, PYXIS; two med carts (code --),
FSBS supplies
Dirty linen hampers
White charge sticker book, clean linen, specimen cups, culture swabs,
cotton swabs, tongue depressors, isolation supplies (face masks, gowns),
pampers and pads, disposable BP cuffs, disposable ear pieces for
Tympanic thermometers, bath basins, emesis basins, denture cups,
toiletry and hygiene items, 02 masks and tubing, dressing change
materials, hats and urinals, Foley catheter kits, suction supplies, Fleets
enemas, tube feeding supplies, post mortem bags, Hoyer lift pads
Bath tub
Telemetry patient rooms
Change of shift conference. Employee refrigerator and microwave.
Can only drink and eat in this room. Put your book bags in here.
Clean IV pumps, scales, Hoyer lift, enteral feeding pumps, sterile gloves,
copier
Dirty linen hampers
Wound care supplies, sterile drapes, sterile gloves
Hoyer lift
Clean bedside commodes, walkers, shower chair, baby scale
Patient refrigerator, coffee, ice machine, plastic utensils, salt and pepper
packs, crackers, sugar packs
On floor, report on to your nurse, eyeball patient, check ACCU check results and 0600 VS results
(notify instructor of results); check charts, check labs; check MARS
Pt head-to-toe assessment (report abnormals to instructor AND primary nurse)
Insulin, oral antihyperglycemic agents, prevacid, synthroid med passes
Pass breakfast trays, assist patients with eating
Bath and bed changes, activity (OOB, walk, etc.). Make sure you are keeping your immobile
patients turned Q2. Check for any new labs in green chart (notify instructor and primary nurse of
abnormals).
Vital signs performed and charted (report abnormals to instructor AND primary nurse), I & O and
pt turning charted, pt head-to-toe assessment charted, first narrative note charted (in both nurse's
progress notes and interdisciplinary care plan documentation record). For the interdisciplinary care
plan documentation record, choose two high-priority nursing diagnoses for your patient and
comment on these. Change continuous IV fluid bags, if hanging past 24º.
Main medication pass (BE PREPARED) - make sure throughout your shift that all your meds are
in the drawer; if not, call pharmacy **** (will be in at 0800 to stock med carts)
Check off all treatments done in treatment book (IV site care, Foley care, OOB in chair, diet,
bleeding precautions, labs, one-time orders, I & O, 02 @ 2 L, daily weight, VS q4 and pulse ox)
ACCU check; bath, bed change completed. Pt activity completed. Last entry in narrative. I & O
flow sheet complete. Report off to primary nurse.
Post-conference (Room ...)
***REMEMBER TO CHART Q2 NARRATIVES and any abnormals in nurse's progress notes. TEAMWORK IS IMPORTANT. IF
YOU ARE FINISHED WITH YOUR PT, SEE IF YOUR FELLOW STUDENTS NEED
ASSISTANCE!!!! (DON'T disappear in the conference room, working on your school paperwork
during clinical time.) Prioritize your time and stay focused. Try to get the most out of your clinical
time. Communicate well with the nursing staff and actively look for procedures to do on the floor,
in outpatient, or in the ED.