PEDIATRIC SKILLED NURSING POLICY AND PROCEDURE MANUAL. Sample Home Health Agency

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1 2013 PEDIATRIC SKILLED NURSING POLICY AND PROCEDURE MANUAL Sample Home Health Agency

2 Pediatric Nursing is a nursing specialty that is provided to children in their places of residence. Because of this service, children who would otherwise be in hospitals or long term institutions can enjoy the comforts of home and family. These procedures were designed to be used in conjunction with the home health care general policies prepared by 21 st Century Health Care Consultants. This manual contains the most current federal regulations and practices to the best of our knowledge. However the information in this manual may change from time to time consistent with federal and state regulations. 21 st Century Health Care Consultants disclaim responsibility for any adverse effects resulting directly or indirectly from the use of this procedure manual, from any undetected errors, and from the user s misunderstanding of the text. Infection Control Policies Page 2

3 Table of Contents SECTION I - SKILLED NURSING STERILE TECHNIQUE PROCEDURE CAST CARE SPICA CASTS AND BODY CASTS BUCK S TRACTION CATHERIZATION CARE OF INDWELLING URINARY CATHETER CATHERIZATION INSERTION OF INDWELLING URINARY CATHETER CATHERIZATION REMOVAL OF INDWELLING URINARY CATHETER CATHERIZATION STRAIGHT CATHETER PROCEDURE DIABETIC TEACHING END STAGE DISEASE SERVICES NEWBORN NURSING ASSESSMENT HOME NURSING OF THE POST-PARTUM MOTHER & INFANT HOSPITAL EVALUATION & DISCHARGE PLANNING NURSING BAG MANAGEMENT NURSING SUPERVISORY VISIT PH PROBE STUDY PLACEMENT & MONITORING CHEST PHYSIOTHERAPY & POSTURAL DRAINAGE BULB SUCTIONING NASOPHARAYNGEAL AND TRACHEAL SUCTIONING THERMOREGULATION TRACHEOSTOMY CLEANING OF SUCTION CATHETERS & CONNECTING TUBING TRACHEOSTOMY STOMA SITE CARE TRACHEOSTOMY SUCTIONING Infection Control Policies Page 3

4 1.24TRACHEOSTOMY TIE CHANGE TRACHEOSTOMY TUBE CHANGE TRACHEOSTOMY TRANSITION TO HOME URINE SPECIFIC GRAVITY MEASUREMENT WOUND CARE ASSESSMENT, CLASSIFICATION & STAGING WOUND CARE DRESSING CHANGES SECTION II LABORATORY PROCEDURES CENTRAL LINE CATHETER BLOOD DRAW DORSAL VENIPUNCTURE PROCEDURE GLUCOSE TESTING USING GLUCOMETER GLUCOSE TESTING USING TEST STRIPS HEEL STICK PROCEDURE IMPLANTED VASCULAR ACCESS DEVICE CATHETER BLOOD DRAW PERIPHERAL BLOOD DRAW PERIPHERALLY INSERTED CENTRAL CATHETHER BLOOD DRAW SPUTUM CULTURE COLLECTION STOOL TESTING CULTURE & SENSITIVITY, OCCULT BLOOD, OVA & PARASITES TRACHEAL GASTRIC Ph & GASTRIC OCCULT BLOOD TRACHEAL ASPIRATE COLLECTION URINE TESTING USE OF THE LABSTIX/MULTI-STIX SG REAGENT STRIPS SECTION III MEDICATION ADMINISTRATION Administration of Medications: General Guidelines EYE DROP/OINTMENT ADMINISTRATION INHALED MEDICATION METERED DOSE INHALER (MDI) Infection Control Policies Page 4

5 3.04INTRAMUSCULAR MEDICATION ADMINISTRATION CEREDASE INJECTION (ALGLUCERASE) SYNAGIS ADMINISTRATION ADMINISTRATION OF INTRAVENOUS ALBUMIN ADMINISTRATION OF INTRAVENOUS AMPHOTERICIN B INTRAVENOUS ANTIBIOTICS (PIV) AND (VAD) USING A SYRINGE PUMP ARA-C ADMINISTRATION PROCEDURE (CYTOSINE ARABINOSIDE) CYTOSAR, ARA-C, CYTARABINE CHEMOTHERAPY ADMINISTRATION VIA LONG-TERM VASCULAR ACCESS DEVICE DEFEROXAMINE ADMINISTRATION FACTOR VIII ADMINISTRATION GANCICLOVIR (DHPG) IV FLUSH GUIDELINES Heparin Grid A: Use to Complete Plan of Care (POC) Heparin Grid B: Dose to be given ADMINISTRATION OF IV IMMUNE GLOBULINE NASAL MEDICATION ADMINISTRATION DESMOPRESSION ACETATE (DDAVP) ADMINISTRATION ORAL MEDICATION ADMINISTRATION DIGOXIN (LANOXIN) ADMINISTRATION ADMINISTRATION OF MEDICATIONS INTO OUTER EAR CANAL RECTAL MEDICATION ADMINISTRATION SILVER NITRATE APPLICATION SUBCUTANEOUS MEDICATION ADMINISTRATION EPOGEN (EPOETIN ALFA) Infection Control Policies Page 5

6 3.27GCSF (NEUPOGEN) (FILGRASTIM) GROWTH HORMONE ADMINISTRATION INSULIN ADMINISTRATION USING SOFT POCKET TECHNIQUE TOPICAL EMLA CREAM ADMINISTRATION WYDASE (HYALURONIDASE) ADMINISTRATION SECTION IV HIGH TECH POLICIES APNEA MONITOR ENTERAL INFUSION PUMPS FOR CONTINUOUS DRIP FEEDINGS INFUSION PUMPS MECHANICAL VENTILATION IN THE HOME AEROSOL THERAPY (NEBULIZER) CARE & MAINTENANCE OF HAND-HELD NEBULIZER HOME OXYGEN THERAPY VIA NASAL CANNULA PHOTOTHERAPY CENTRAL LINE CATHETER ADMINISTRATION OF IVP MEDICATION CENTRAL LINE CATHETER ADMINISTRATION OF IV HYDRATION FLUID CENTRAL LINE CATHETER ADMINISTRATION OF TPN/IL CENTRAL LINE CATHETER CAP CHANGE / ANTI-REFLUX VALVE CENTRAL LINE CATHETER DRESSING CHANGE CENTRAL LINE CATHETER HEPARINIZATION CENTRAL LINE CATHETER REPAIR - PERMANENT CENTRAL LINE CATHETER REPAIR - TEMPORARY CENTRAL LINE CATHETER SITE & LINE CULTURE CENTRAL LINE CATHETER USE OF UROKINASE EXTRAVASATION TREATMENT / DOCUMENTATION Infection Control Policies Page 6

7 4.20IMPLANTED VASCULAR ACCESS DEVICE ADMINISTRATION OF IV HYDRATION IMPLANTED VASCULAR ACCESS DEVICE ADMINISTRATION OF IVP MEDICATION IMPLANTED VASCULAR ACCESS DEVICE ADMINISTRATION OF TRN/IL IMPLANTED VASCULAR ACCESS DEVICE CATHETER CARE & MAINTENANCE IMPLANTED VASCULAR ACCESS DEVICE - HEPARINIZATION IMPLANTED VASCULAR ACCESS DEVICE INSERTION OF HUBER NEEDLE IMPLANTED VASCULAR ACCESS DEVICE REMOVAL OF HUBER NEEDLE IMPLANTED VASCULAR ACCESS DEVICE SITE & LINE CULTURE PERIPHERAL IV ACCESS & INSERTION PERIPHERAL IV ADMINSITRATION OF IVP MEDICATION PERIPHERAL IV ADMINISTRATION OF IV HYDRATION PERIPHERAL IV - DISCONTINUATION PERIPHERAL IV - HEPARINIZATION PERITONEAL DIALYSIS CATHETER EXIT SITE CLEANING & DRESSING CHANGE PERITONEAL CATHETER EXIT SITE CULTURE PICC LINE ADMINISTRATION OF IVP MEDICATION PICC LINE ADMINISTRATION OF HYDRATION PICC LINE ADMINISTRATION OF TPN / IL PICC LINE CAP CHANGE / ANTI-REFLUX VALVE PERIPHERALLY INSERTED CENTRAL CATHETER - DRESSING CHANGE PERIPHERALLY INSERTED CENTRAL CATHETER - HEPARINIZATION INSERTION OF A PERIPHERALLY INSERTED CENTRAL CATHETER LINE Infection Control Policies Page 7

8 (PICC / PIC) PERIPHERALLY INSERTED CENTRAL CATHETER - REPAIR (TEMPORARY) PERIPHERALLY INSERTED CENTRAL CATHETER REMOVAL PERIPHERALLY INSERTED CENTRAL / MIDLINE CATHETER SITE & LINE CULTURE PERIPHERALLY INSERTED CENTRAL / MIDLINE CATHETER USE OF UROKINACE GASTROSTOMY CARE GASTROSTOMY BUTTON REPLACEMENT REPLACEMENT OF GASTROSTOMY TUBE ADMINISTRATION OF TUBE FEEDING BOLUS, BAG METHOD USING NASOGASTRIC TUBE, GASTORSTOMY TUBE, PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE, OR JEJUNOSTOMY TUBE ADMINISTRATION OF TUBE FEEDING BOLUS SYRINGE METHOD USING NASOGASTRIC TUBE, GASTROSTOMY TUBE, PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE, OR JEJUNOSTOMY TUBE ADMINISTRATION OF MEDICATION THROUGH NASOGASTRIC, GASTROSTOMY OR JEJUNOSTOMY FEEDING TUBE ASSESSMENT OF GASTRIC RESIDUAL GAVAGE FEEDING: INTERMITTENT FEEDING VIA ORALLY / NASALLY PLACED GAVAGE TUBE JEJUNOSTOMY CARE PLACEMENT & VERIFICATION OF NASOGASTRIC FEEDING TUBE FOR CONTINUOUS FEEDING PROCEDURE Infection Control Policies Page 8