Lab Call-backs, GST Break-Room, Splints, Dilaudid Shortage, FED Holds
GST Staff Break-room: Please be conscientious of using the recliner in the staff break-room. That is a community break-room, and it is NOT intended to be used as a ‘sleep-room’. Feel free to go relax and decompress for a bit, but please do not ‘set up shop’ with blankets and pillows and shut the door with the lights off. That is the only area of the building that anyone can get a chance to decompress and it is not fair to restrict the nurses from using it. If time permits and you want to get some shut-eye, then use a clean patient room.
Lab Call-Backs: I know some have had some consternation over the “outpatient labs results” basket by the physician work-station. Anytime we are on shift, we need to go through these regularly.
Positive - we need to call and document this call in the chart. If no answer, then write the ‘date/time/no answer/signature’ on the physical paper, so we can try again later.
Negative - can give to the nurses go call the patient.
Splinting Inservice: I am excited to have Mariela Rico with AdaptHealth DME Orthotics provide individual in-services on all of the splints we stock at the FEDs. Please welcome her when she arrives! I have arranged for her to visit each of us in December at 08:00am when we are on shift at TSQ. I have asked her to stock some new splints for boxer-fractures, distal radial fractures, locking knee splits, LSO and TSO, among others. If there is a specific splint you think would be useful, let me know so we can get it stocked.
Dilaudid Shortage: There is a national shortage of IV hydromorphone, and we are reaching critically low levels at the hospital. We will not be able to replenish the supply at the FEDs at this time. GST has only one vial left, and TSQ has 12 left. The estimated resupply dates range from beginning-to-mid December, so hopefully this will be a short-lived shortage. IV morphine and fentanyl are still readily available at this time.
Tuesday, December 07, 2021 @ 06:30pm
Please RSVP for this program by using the following link:
http://www.medforcereg.net/SALG132590
FED Admission Holds
This is becoming an issue again; I wanted to review our transfer process. Please review the flow policy which actually has the patient transfers to be out of units in 30 minutes; however, this was pre-covid with issues that we have never faced before. FED patients will be given room assignment priority.
<CLICK HERE TO READ THE FLOW POLICY>
The physician will put a decision to admit in Cerner
Either the physician will call the transfer center or they may ask the nurse to call and ask if a MS/ICU bed will be available in the next 4 hours.
IF YES – physician will admit per usual process by securing an admitting physician and place the AOT order in Cerner and the RN will be in contact with the inpatient RN and call the ambulance for transfer as soon as the room is available.
IF NO – physician can pursue transfer to other facility: ED to ED or Direct Admit beginning with BSA
If no other admission avenue is available and the patient is appropriate for NW Services, the physician will admit to NW and the FED CN will work with the ED CN to initiate an ER to ER transfer. It is an expectation that both CNs will act with courtesy and respect in working out a transfer plan.
If the ER to ER transfer is not going smoothly, the RN will call the house supervisor for assistance. The house supervisor will assist in a transfer plan and/or escalate the issue to the AOC as needed.
