Patient Care Matters - May 2021
The Nursing and Clinical information you need to know
Patient Care Matters is created by nursing and clinical leadership to highlight patient care initiatives, relevant clinical information and important news that will support the mission of Cape Cod Healthcare: To coordinate and deliver the highest quality, accessible health services, which enhance the health of all Cape Cod residents and visitors.
Familiar faces arrive in new positions
- Nurse Manager, MS4: Barbara Pecorella
Cape Cod Hospital
- Nurse Manager, North 3: Ivone Bennett
- Nursing Supervisor: Laurie David
- Nursing Supervisor (Operating Room): Robert Folan
Residency Program Updates
In April, 25 RNs completed training and have now moved into their permanent positions. Congratulations to these 17 nurses at CCH and eight at FH.
Will Train Programs
CCH Emergency Center: Six nurses are currently participating in the Emergency Center Will Train program. This group is due to finish in June and the next cohort will begin in July. Currently 2 nurses have accepted and we are recruiting for 4 more candidates.
FH Intensive Care Unit: Program to start 5/9; completion in September- new will train in planning stage for late Summer.
Process Improvement Updates
Cape Cod Hospital has remained below the national benchmark of 2.34 for both March and April and Falmouth Hospital met the benchmark in April. Such great work – let’s keep it going!
- Falls prevention continues to be a top priority at both CCH and FH.
- Falls assessment, rounding, bed/chair alarm placement is an essential tool.
- Falls rounding has begun with success at FH and will begin in the week of May 9 at CCH.
Posey Sitter On Cue Alarm tips for success
The Posey Sitter On Cue Alarm is a restraint-free solution engineered to alert caregivers of a potential falls risk, giving them more time to react and intervene when every second counts.
Tips for success
- The alarm should really never be shut off. There is a power on and off switch on the back of the alarm, leave it on
- Be sure the sensors (chair or bed pad) are connected
- Place the patient on the sensor
- Remember to check the batteries. We will be looking to choose a scheduled battery change date each month- more information coming soon!
- Using Hold: BE VERY CAREFUL TO NOT LEAVE THE PATIENT ON HOLD WHEN THEY SHOULD BE ALARMED. To initiate Hold, press the HOLD button for 1 sec to turn the status light to RED
- After 30 secs, if weight is placed on the sensor or never removed, there will be a single beep and monitoring will resume
- If there is no weight on the sensor after 30 seconds the alarm will remain on hold
GREEN MEANS GO. RED MEANS NO.
PI Update: CAUTI/CLABSI
CAUTI and CLABSI Prevention Tips
By Kristine Morse, Nurse Manager Intensive Care Unit, Falmouth Hospital. Zero Harm is the goal for CCHC!
CAUTI (Catheter Associated Urinary Tract Infections)
- Please continue to evaluate each shift if a Foley catheter can be removed
- The MDs are ordering the nurse-driven Catheter Removal Protocol more, so this gives you the ability to discontinue the Foley catheter when it is no longer needed, per the recommended guidelines.
- Eliminating the use altogether will not happen, however, removing them as soon as possible is very helpful in reducing the patient’s risk of a CAUTI
- Remember each day a Foley catheter remains in place the patient has a 3-7% chance of getting a CAUTI
- Our usage has decreased some so that is good – we can do better, though! I know we can!
- Don’t forget to consider an external catheter first!
CLABSI (Central Line Associated Blood Stream Infection)
- A good rule of thumb is to treat that central line like you would if it was a part of your family’s care. If you have a patient with a Triple Lumen or PICC line, remember to ensure the dressing is dry and securely intact, and blue alcohol caps are on all ports when not in use and all open ports on IV tubing
- Ensure the securement device is intact or sutures are present and that the dressing and tubing are dated appropriately and legible
- Most important – ask every shift, every day – does this patient still need this line?
- Removing lines as soon as possible reduces the risk of infection. Never putting one in is the best, but we all know that is unavoidable in some of our patients
- Also, if your patient has a femoral central line it should be replaced in 24-48 hours or sooner, if able. The femoral site is high risk for infections
- Have you had trouble keeping your central line dressing intact? Replacing it sooner than every 7 days?
- We are currently reviewing a much better option for central line dressings – more information to come!
PI Update: Early Discharges
Update presented by: Kathie Cole, Manager Case Management, Cape Cod Hospital
Kick Off: Monday, April 26, 2021
Pre-booked discharges by defined time (i.e., 4 DC’s pre-booked by 11am.) DC will occur within 30m of that pre-booked time.
Efforts towards meeting early DC goals include:
- Interdisciplinary team huddles to determine discharge needs
- Agree on DC plan
- Arrange transportation
- Notify family or facility of DC times
- Discuss pre- books at huddles
- Units prepare evening prior
- Enter pre- book info into EPIC so it will show in census
“This new process takes out the guess work for patients and families during their stay. We have an established discharge time that works for patients and their caregivers. There are no surprises for the physicians and the nursing staff because they’re part of the conversation”
- Libby Merritt, Case Manager, Mugar 6
2021 Annual Mandatory Training Assignment in HealthStream
Deadline: May 31, 2021
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- Completion of Mandatory Annual Training (MAT) is required for all CCHC employees and contracted staff
- The training will be assigned to you via the Health Stream Learning Center
- This training should be completed during your normal work hours
- This training needs to be completed by May 31, 2021