TOPIC DISCUSSION CONCLUSION

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1 Maternal Child Staff Meeting June 14, 2011 Pediatrics Presiding: Warren BSN, RN (Interim Manager) Present: Denise McElwain Sec/Tech, Marcy Chambers RN, Bernadette Golt RN, Jennie Chambers RN, Karyn Messick RN, Jan Smith RN Recording: Jan Smith RN TOPIC DISCUSSION CONCLUSION Approval of minutes Approval ACTION/ FOLLOW- UP Health Stream T&A s Kudos to all Peds staff for keeping up with and completing all the items on there list. Order sets need updating - Did a group of you work on this? Contacting MD s to see what they would like on the order sets Getting pharmacy involve etc. Jan will help but need help from the staff. Is this started or done and who was helping. New items added to Health Stream regularly. Please check frequently. Many are going to be done as out pt. Will hold until we find out if needed. Stocking Not always stocked well. New stocker Deveron often misses items needed and stocks items not needed. Denise to show him how to look at the pars on the unit. Did Denise show him and is it better. Doing better with notes and follow-up. Productivity Remains at 100% Schooling or Anyone else going Jennie working on Masters and Certifications Karyn working on pre Time clock Hospital Survey Action Plan Please do not punch in before 0650 and must punch out by 1930 if not busy Kudos to the entire staff you guys are doing great. 1. I feel free to tell my supervisor what I think. Glad to be able to voice there opinions. Bachelors Keep up the good work..call or come to office when you need to. 2. Improve information dissemination via hospital , posting, and verbally to all staff on all shifts. They Like s Letters 1

2 Safety ER Report sheet Flexible Scheduling Self Scheduling Committee chairs to post minutes explaining what they are working on. OB/Peds Committee MM need to be posted on both units sometimes Peds unit feels like they don t always get all the information provided to staff. Is this any better Cuddles Security System on both the Birthing Center and Pediatrics Guy will be around looking at the ceilings to see how they will be able to run the wires. Installing around middle of July now. Education will begin a little before installation. Need Volunteers to train so they can train others. Jenni and Bernadette working on for Frontline leadership projects. Where are you with this? Staff interested. Diane finding out what other hospitals are doing with Pediatric units. Did Diane get back to you guys about this. Staff looking into self scheduling modules. Connie spoke with ICU which is a small unit and they do self scheduling and they have no written guidelines. Jenni has spoken to the ER staff and they love self scheduling. So where do you guys want to go with this? Yes it is better but need Global information coming out sooner. Would like OB MM and Peds MM. Rep to come on June 22 nd to look at wiring and exits. Denise and Karyn volunteer to be trainers. It is in the works with IT. IT working with Chester River probably done in Oct. Staff can print out and start working with. No one has heard from Diane. Jan to call Diane and see what is happening in other hospitals. Starting with this schedule to come out soon to staff. Then will need time to adjust. Alcohol to Cords Working well per MDs. No infection noted. Nurse Credentialing Must be done by June 15 th. Remember to submit it. If having problems let or Dian Walbridge know. Birth Certificates Be aware that they need to be completed within 24hrs. Vilma will chase you down to get them. Apparently we got a below normal score for our report card. Badges It has been noted that there are people who can swipe their badges and walk onto OB that are not suppose to be coded. Please let me know if you notice anyone that shouldn t be coded. Pharmaceutical Waste The changes will happen around June 28 th, Representatives will be around to do a brief education session as a follow-up to the online ed. Nursery information sheets New information sheets have been created to help the Nsy nurses know about all the babies on the unit. We hope that Complete online education so you won t be left in the dark. Jan Jan 2

3 this will help with communication between nurses and the Peds MDs. This way they do not have to chase down each nurse taking care of there pts. Fish tank Again thanks for taking that on. Team Stepps Introduction classes are posted please come. Highly encouraged. Staff Concerns IV Stat lock Inservice July & Evidence based practice IV site checks Q 1 hr birth to 1 yr. age 1-14yr Q 2hrs. NDNQI Pain air assessments Pain reassessments aren t being done in a timely fashion. If put pt declined then don t need to reassess or put pain tolerable. Anything else needs to be reassessed. Sickle Cell & PCA order sets Approved by Pediatricians Reactive Airway Order Set Karyn will take to Peds. Meds tracker need to add asthma to with possible discharge orders. Bladder Scanner Dr Ceppedes has us to do frequent scans on her pts. We have to borrow all the time when it may be inconvenient for the other floor. Maternity leave for Ashlea may need another sec tech on the unit. Pediatric pt census Can we find out the Peds pts average length of stay in the ED Pull schedule list need to keep one in the book. Discussed being pulled to the BC sometimes when not needed. Discussed being pulled to ER for 1: And pt never coming in. Representatives will be here Karyn putting together a helpful hint book and samples of correct/incorrect reassessments. Given to P&P com. And then to pharmacy. Can we get our own? Will look at in the near future. to check with Grace Gonzalez in the ER Jenni & Vonnie Karyn & all Jenni Rob Carroll All Next staff meeting July 12 th 6pm 3

4 Maternal Child Staff Meeting June 14, 2011 Birthing Center Presiding: Warren BSN, RN (Interim Manager) Present: Lynn Crouch RN, Sandy Simmons RN, Priscilla England RN, Amy Forrest RN, Aymee Gonzalez RN, Debbie Correa US, Sonia Dutt RN, Julie Callahan RN, Karen VanTrieste RN, Recording: Lynn Crouch RN TOPIC DISCUSSION CONCLUSION Approval of minutes Approval ACTION/ FOLLOW- UP Schooling or Anyone else going Amy Forrest near future Certifications AWHONN EFM Nurse Credentialing Must be done by June 15 th. Remember to submit it. Positions 0.9 position staff nurse we are currently interviewing. Nurse Manager position start interviewing on Friday Karen VanTrieste position of clinical nurse educator a PT (.5) Will not be filled until after new manager has been filled. Nursery Project The Nsy nurse and other staff are coming in at 0630 to assist the MDs in the Am for rounds. We are doing a 2 month pilot. We are documenting the times MDs arrive to the unit and if any complaints are lodged. A survey was given to the Pediatricians about what their concerns are. The results are in and the two major concerns are this: 1. Not all the information they need is in the medical record. 2. Staff are not familiar with my patients was a concern with half of the Pediatricians. We are working are these areas of concern. Nsy information sheets have been created to help the staff who are assigned to the Nsy know more about all the babies so they may answer questions the MDs may ask. The night shift prepares the information sheets for the on coming Nsy nurse and then they are to stay to help til There is a book in the Nsy of Vonnies to Document MD time of arrival. DR need /problems. Time code Delays The OR has started doing time code delays which is noted on Started the 8 th of June 4

5 Badges Shift huddles the current OR sheet. It is to be a discussion between the circulator, MD and Anesthesiologist as to what the code should be if a schedule CS was delayed. If a pt is scheduled for 0745 then the pt should be in the room by that time. That means the anesthesiologist and MD has seen the pt and are ready for the pt. It has been noted that there are people who can swipe their badges and walk onto OB that are not suppose to be coded. Please let me know if you notice anyone that shouldn t be coded. These are not being done so we need to start. Oncoming shifts are to wait to see pts until the huddle is over. Doctors, volunteers, Med. Rec people etc. Let know if you guys notice anyone that shouldn t have access. Staff like the name cuddles instead of huddles. They need to be done. Call Hours Call hours are done to meet the ratios needs of the unit. Is done per need at the time for the schedule it will fluctuate according to FTE needed. There are several FTE that are out of staffing right now. I am looking for per diems and fill vacancies as fast as poss. Carol keeps track of call given to whom on each schedule and adjusts as needed. Transport of Newborns Birth Certificates Health Stream / Annual Education The Director of performance measurement and improvement is using our logs for statistical purposes so these must be done on any transport. Please. Be aware that they need to be completed within 24hrs. Vilma will chase you down to get them. Apparently we got a below normal score for our report card. This is a state requirement. I have called the Vital Records 2 times and no one has called me back yet. If the pt can t give us a name yet then it goes down as Baby girl or Boy. Please explain the importance of getting them done for the state. It will cost them money to have it changed. There are items added all the time so please check often. EFM is online now and mandatory for all L&D staff. There are 7 modules and please take your time and do the modules with case studies it is very educational. Don t rush through them. 5

6 OBTV in the OR Urine controls ACOG task force has 6 sub committees- Update R &R Hospital Survey Action Plan You can save and quit and then come back to where you were. Wiring is being done to change where the computer is in the OR. When complete it will be at the back of the room out of the way of the door and anesthesiologist. The controls will be changing soon to a new type so they may look different. The documentation sheets will be changing also. Be aware Is mostly complete. Some items are still being worked on such as the Nursery project, statistical items and registration. Some problems with the registration printer. Quick registration, transport by the ER techs, completed registration on the floor later. Mary Delashmutt bringing Bahaman RNs were here. Everything went well. They thank us for being so educational and informative. Thanks to all the staff. 1. Workloads in Department distributed fairly. Guidelines were put out to help better plan. We will soon have OBTV at the back of the OR, giving more space where the door is. We will need to monitor how this is working, let know when problems arise so she can get them taken care of. Remember new changes to how processes are done will have some issues to iron out be patient and be nice. sent to everyone . The Doors Posting schedule C/S orders 2. Important information communicated effectively. - Improve information dissemination via hospital , postings, verbally to all staff on all shifts. -Committee chairs to post all MM-putting out MM to all - Off going shift huddles - Not being done Is this any better do you feel like you are getting the information in a timely manner. Concerns: Pt can t get snacks from waiting area Triage pt can t do the circle walk. Have to be answering the door bell all night for visitors just going to get a snack. The posting office is faxing over orders for scheduled C/S. Make them a part of the admission orders add them to order section in the chart. Posting orders may need to be rewritten and faxed to pharmacy and it is not being done. Charge nurse Classes will be coming up in the fall if you are interested 3 staff is interested. 6

7 contact Carol. I will post the date soon. Staff Concerns IV Stat lock Inservice July & Evidence based practice IV site checks Q 1 hr birth to 1 yr. age 1-14yr Q 2hrs. Being pulled We have to look at staffing ratios and remember Peds staff doesn t take care of M/Bs up here that often. As an example BC nurses going to Peds and taking 4-5 Peds pts when we are not that comfortable. Remember pull only if needed and if you are not if you should pull from Peds call me and I may be able to help with the decision process. Personal Fans Call plant ops for Fans if your pt requests one. These must go home with the pt. Summer interns have been assigned to nurses, must do 200 hours. One from Chesapeake and one from Salisbury Educational packets Education comm... has worked hard to get these ready for summer education. They will be on a clipboard in the conference room. You will get your own sign off list in your mailbox. Please remember to check your mailbox whenever here. Pt bands and scanning There is some difficulty scanning bands that have wrinkled bands that were not put on properly. Please be aware when placing bands on pt. Dishes some dishes have gone missing. Staff need to clean up own dishes that are used. Whoever is tossing the dishes please stop. Glucometer when needed stat hard to get to work right. Suggested to put in 12 0s or 0s and the room number or band number. Representatives will be here Tech being pulled for 1:1 from the BC should be called first. Please be supportive and helpful. Thanks to Lynn and the Ed comm... Would like to see those who use and dirty dishes clean up after themselves. We may start checking everyday before change of shift. Lisa Lyons aware but still has to have 12 characters. Jenni & Vonnie Next staff meeting July 12 th 2pm conference room. 7