Episodes

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June 25, 2018
Ep049 Protect Patient from Injury
Falls: initiate fall risk care plan if appropriate, make sure patient is safe to ambulate, initiate all fall precautions Electrical hazards Unsafe behavior from other patients or visitors
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September 4, 2017
What Was it Like to be a Nurse During Hurricane Harvey? Nurse Erika Share Her Story
When a natural disaster strikes, patients don’t magically stop being sick.  I am honored to share the story of Erika RN BSN, who stayed in the hospital 108 hours during Hurricane Harvey providing care for her patients. I am honored … Continued
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19 min
August 2, 2017
Ep080 Safety and Infection Control Use of Restraints Monitorevaluate patient response to restraintssafety device
Evaluate routinely, based on kind of restraint IE if it’s a violent restraint, q15 min at minimum Assess skin q30min, remove q2hr and provide ROM, fluids, toileting, food, and so forth Renew order if still needed
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July 31, 2017
Ep079 Safety and Infection Control Use of Restraints Follow requirements for use of restraints andor safety device
First try alternatives and document that… then use lease invasive restraint or safety device Notify MD and obtain appropriate order, document! Follow facility’s policy to a tee Use appropriate tie/knot – “quick release” Always secure to the bed and not … Continued
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July 28, 2017
Ep078 Safety and Infection Control Use of Restraints Assess appropriateness of the type of restraintsafety device used
Have all other alternatives been attempted? Family/friend at bedside Alarms Regular bathroom attempts and food/fluids offered Promote relaxation Remove unnecessary lines, tubes, equipment Provide familiar material Reorientation Address pain, nausea, anxiety and so forth Frequent rounding Ambulate regularly, if appropriate … Continued
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July 26, 2017
Ep077 Safety and Infection Control Standard Precautions Evaluate whether aseptic technique is performed correctly
Great reference for this:  Common Breaks in Sterile Techniques, published by the AORN Journal Common breaks Not noticing compromised packaging Not noticing moisture on or in the package Unsterile person touching the sterile field Outside, unsterile packaging, touching inside sterile … Continued
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July 24, 2017
Ep076 Safety and Infection Control Standard Precautions Evaluate Infection Control Precautions Implemented by Staff Members
Hand washing compliance is being met Trash is disposed of properly Staff is consistently wearing appropriate PPE
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July 21, 2017
Ep075 Safety and Infection Control Standard Precautions Use Appropriate Technique to Set up a Sterile Field
Definition Sterile gloves, mask, and other necessary sterile supplies Maintain sterile technique Follow appropriate protocol if sterile field is broken
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July 19, 2017
Ep074 Safety and Infection Control Standard Precautions Utilize Appropriate Precautions for Immunocompromised Patients
Varies depending upon facility.  Can include: No fresh flowers or fruits Ill visitors are not permitted Many people institute or order “reverse isolation” however, per the CDC it “was not found to improve outcomes for neutropenic patients, and isolation is … Continued
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July 17, 2017
Ep073 Safety and Infection Control Standard Precautions Educate Patient and Staff Regarding Infection Control Measures
For example; if a patient is on contact isolation, we must educate the patient and family about the use of gowns, gloves, and hand washing, as well as ensure the staff is aware as well (HIPAA compliant signage) before providing … Continued
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July 14, 2017
Ep072 Safety and Infection Control Standard Precautions Follow Procedures when Reporting a Patient with Communicable Disease
Inform appropriate personnel Infection Control department Center for Disease Control Summary of Notifiable Infectious Diseases, CDC (last updated 2014)
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July 12, 2017
Ep071 Safety and Infection Control Standard Precautions Apply Principles of Infection Control
Hand hygiene Washing hands thoroughly at appropriate times Surgical asepsis AKA sterile technique Maintaining sterility, sterile items may only touch other sterile items Isolation Appropriate room assignment (private room, or may share a room with a patient with similar pathogen … Continued
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July 10, 2017
Ep070: Safety and Infection Control Standard Precautions Understand Communicable Diseases
Airborne – isolation room, negative pressure room, must wear appropriate mask and additional PPE (gown, gloves) Measles Varicella Tuberculosis Droplet – isolation room, surgical mask okay, gown, gloves Meningitis Pertussis Pneumonia Influenza Contact – isolation room, gown and gloves Colonized … Continued
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July 5, 2017
Ep069: Safety and Infection Control Standard Precautions Assess Patient Care area for Sources of Infection
Whenever you’re providing care, ensure you’re keeping everything clean (or sterile, if required) Examples of situations… When you remove the cap from the spike on your IV tubing to start IV fluids, it cannot touch anything else other than sterile … Continued
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July 3, 2017
Ep068: Safety and Infection Control Security Plan Use Critical Thinking in Situations Related to Security Planning
Apply principles of triage and evacuation procedures/protocols Check out Episode 059 for triage principles Know how to evacuate patients Horizontally before vertically Know what to do for specific units Know how to use specific equipment to quickly transfer patients Medsleds … Continued
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June 30, 2017
Ep067: Safety and Infection Control Safe Use of Equipment Inspect Equipment for Safety Hazards
Examples of equipment include frayed electrical cords, loose/missing parts, IV pumps that malfunction, exposed wiring All equipment must be inspected and signed off on before using with a patient If a patient brings in their own electrical equipment (like a … Continued
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June 28, 2017
Ep066: Safety and Infection Control Reporting Incident Identify Where Reporting of Incident is Appropriate
Acknowledge and document practice error per policy For example, medication error, accidental needlestick, incorrect order entry, patient transferred to incorrect unit Evaluate response to error/event/occurrence Evaluate patient Does a process need to change to prevent this from occurring in the … Continued
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June 26, 2017
Ep065: Safety and Infection Control Home Safety Assess Need for Patient Home Modifications
Examples include lighting, handrails, kitchen safety Apply knowledge of patient pathophysiology to home safety interventions Are they hard of hearing, have visual deficits? Do they have the dexterity to use handrails or a LifeAlert? Can they use their home oxygen/respiratory … Continued
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June 23, 2017
Ep064: Safety and Infection Control Handling Hazardous and Infectious Materials Safe Internal Radiation
Never touch the device/implant Label things appropriately Follow protocol/policy/procedure specifically Ensure patient is in private room to prevent exposure to other patients and their loved ones Maintain distance between yourself and device consistently If necessary use shield (like lead apron) … Continued
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June 21, 2017
Ep063: Identify Bio-hazardous, Flammable and Infectious Materials
Follow procedures for handling biohazardous materials Ensure proper labeling is in place For example, linen used with a patient with chemotherapy Demonstrate safe handling techniques to staff and patient Never recap needles, can result in a needlestick Utilize proper storage … Continued
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June 19, 2017
Ep062: Use Ergonomic Principles When Providing Care
Assistive devices: use lifts as often as possible with appropriate staff and supplies, prepare client for use of lift, try to allow time to use lift Optimize bed height every single time Raise bed so you are not bending for … Continued
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June 16, 2017
Ep061: Provide Instruction and Information to Patient About Body Positions that Eliminate Potential for Repetitive Stress Injuries
Carpal tunnel, back injuries are common examples Encourage appropriate body mechanics and not merely treating pain when it occurs Proper posture is essential Encourage working with physician and deciding appropriate supportive devices
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June 14, 2017
Ep060: Assess Patient’s Ability to Balance, Transfer and Use Assistive Devices Prior to Planning Care
Examples of assistive devices: crutches, walker, cane Important to assess their abilities first before coming up with a care plan Don’t assume they can use crutches, plan care, and then find out they have a sprained wrist Not all assistive … Continued
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June 12, 2017
Ep059: Participate in Disaster Planning Activities/Drills
Nurses must participate so their role is known and appropriate Help to identify must-have equipment, potential issues or obstacles to providing care Have an emergency contact tree to contact all staff when/if disaster occurs
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June 9, 2017
Ep058: Implement Emergency Response Plans
Nurses frequently use a color-coding system to triage patients, as identified by the facility Example: Red: highest priority, life-threatening yet survivable injuries Yellow: medium priority, injuries but not life-threatening Green: low priority, can wait an extended time, non life threatening … Continued
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June 7, 2017
Ep057: Use Clinical Decision-making/Critical Thinking for Emergency Response Plan
Complete primary and secondary assessments Primary: identify immediate high-priority needs (think ABC’s) Secondary: identify next priority needs (think getting vitals, neuro, cardiac, pain, history, or focused assessments) When in doubt, think back to your ABC’s and Maslow’s hierarchy of needs … Continued
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June 5, 2017
Ep056: Determine Which Patients(s) to Recommend for Discharge in a Disaster Situation
Important that only the sickest ones are in the facility Think patients on ventilators or respiratory support, on vasoactive medications, patients that would likely die or have profound, life-altering effects  if not receiving care they can only receive in the … Continued
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June 2, 2017
Ep055: Identify Nursing Roles in Disaster Planning
If a disaster occurs, immediately activate the emergency response plan Make sure that you are prepared both at home, at work, and in the community Have an emergency plan and supplies at home and communicate this with those that live … Continued
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May 31, 2017
Ep054: Verify Appropriateness and/or Accuracy of a Treatment Order
Do not blindly follow orders; practice with a questioning attitude Quote from Scrubs, the TV show Nurse (to doctor): “Doug wanted me to give him 500,000 mg of morphine… I thought I’d check with you first before I killed a … Continued
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May 29, 2017
Ep053: Ensure Proper Identification of Patient When Providing Care
You must check their appropriate ID before doing anything Medications: check name, birthday, and so forth Check patient’s armband (or other identifying device) if patient is unable to speak Many facilities require scanning the armband before giving any medications Always … Continued
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May 26, 2017
I’m a Little Bit Scared to Share This #vulnerable
Can I be honest? I had an amazing experience last month.   It was one of those moments when you are filled with thousands of emotions ranging from happiness to sadness all at the same time.  Have you ever felt … Continued
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10 min
May 26, 2017
Ep052: Make Appropriate Room Assignments for Cognitively Impaired Patients
If a patient is confused, impulsive, forgetful, or agitated, make sure they have a room close to the nurse’s station Do not put these patients at the end of the hall, where it’s harder to hear them if they call … Continued
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May 24, 2017
Ep051: Implement Seizure Precautions for At-risk Patients
Many disease processes can put patients at an increased risk for seizures Brain injury or trauma Drugs, medication Withdrawing from alcohol or other drugs Fevers History seizure activity See this list from John Hopkins about various causes of seizures Patients … Continued
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May 22, 2017
Ep050: Review Necessary Modifications with Patient to Reduce Stress on Specific Muscle or Skeletal Groups
Change positions Pillow support Active and passive range of motion Routine stretching of the shoulders, neck, arms, hands, fingers
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May 19, 2017
Ep049: Protect Patient from Injury
Falls: initiate fall risk care plan if appropriate, make sure patient is safe to ambulate, initiate all fall precautions Electrical hazards Unsafe behavior from other patients or visitors
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May 17, 2017
Ep048: Provide Patient with Appropriate Method to Signal Staff Members
Call lights  Adaptive call lights can be used for patients with poor dexterity Phones, or other technology
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May 1, 2017
Ep 047: Safety and Infection Control: Accident Prevention: Idenitfy and Faciliate Correct use of Infant and Child Car Seats
Really important, especially with first time parents Can be easily done incorrectly, not as straightforward as some anticipate Some facilities may have it as part of policy to make sure family knows how to properly use before leaving
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April 28, 2017
Ep 046: Safety and Infection Control: Accident Prevention: Verify Prescriptions that may Contribute to an Accident or Injury
(This does not include medications) At home oxygen and supplies, CPAP’s, assistive devices, drains, tubes, and so forth. Make sure assistive devices are sized appropriately Crutches not too tall, walker not to short, and so forth Make sure they know … Continued
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April 26, 2017
Ep 045: Safety and Infection Control: Accident Prevention: Identify deficits that may impede patient safety
Visual: can they see what’s in front of them while walking? Can they see that they are taking the appropriate medication? Hearing: can they hear someone speaking to them or yelling at them? Can they hear if they are in … Continued
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April 24, 2017
Ep 044: Safety and Infection Control: Accident Prevention: Identify factors that inlfuence accidents
Various factors can influence the likelihood that a  patient will get injured Age and developmental stage: elderly as well patients that may physically be older, but mentally younger Lifestyle: do they use seat belts? Do they drive impaired (alcohol, texting/using … Continued
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April 21, 2017
Ep043: Safety and Infection Control: Accident Prevention: Determine Patient/staff Member Knowledge of Safety Procedures
Many facilities have various protocols on how to deal with various safety issues Falls Armed intruder Large patient influx/at capacity Infant abduction Weather issues Acts of terrorism Unsafe/violent patients or visitors Know what you need to do as a nurse … Continued
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April 19, 2017
EP042: Safety and Infection Control: Accident Prevention: Assess for allergies and intervene as needed
Important to ask about all allergies, not just medication allergies Some medications may have ingredients from different foods in their coating or capsules Must ask about allergies to IV dyes or contrast Ask about all food, environmental, and medication allergies … Continued
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April 14, 2017
Ep041: Management of Care: Referrals: Assess the Need to Refer Patients
Examples of necessary referrals include therapy services (physical, occupational, speech), wound care, nutritional services, and so forth Recognize the need for referrals and obtain necessary orders Identify community resources for the client with health care team (Meals on Wheels, respite … Continued
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April 12, 2017
Ep040: Management of Care: Performance Improvement: Define performance improvement and quality assurance
Performance Improvement (Quality Improvement)   Define performance improvement/quality assurance activities Participate in performance improvement/quality improvement process* Report identified client care issues/problems to appropriate personnel (e.g., nurse manager, risk manager) Utilize research and other references for performance improvement actions Evaluate … Continued
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March 13, 2017
Ep048 Provide Patient with Appropriate Method to Signal Staff Members
Call lights Adaptive call lights can be used for patients with poor dexterity Phones, or other technology
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March 13, 2017
Ep 046 Identify and Verify Prescriptions for Treatments that may Contribute to an Accident or Injury
(This does not include medications) At home oxygen and supplies, CPAP’s, assistive devices, drains, tubes, and so forth. Make sure assistive devices are sized appropriately Crutches not too tall, walker not to short, and so forth Make sure they know … Continued
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March 13, 2017
Ep045 Identifying deficits that may impede patient safety
Visual: can they see what’s in front of them while walking? Can they see that they are taking the appropriate medication? Hearing: can they hear someone speaking to them or yelling at them? Can they hear if they are in … Continued
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March 13, 2017
Ep044 Identify factors that influence accidents and injury prevention
Various factors can influence the likelihood that a  patient will get injured Age and developmental stage: elderly as well patients that may physically be older, but mentally younger Lifestyle: do they use seat belts? Do they drive impaired (alcohol, texting/using … Continued
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March 13, 2017
Ep043 Determine patientstaff member knowledge of safety procedures
Many facilities have various protocols on how to deal with various safety issues Falls Armed intruder Large patient influx/at capacity Infant abduction Weather issues Acts of terrorism Unsafe/violent patients or visitors Know how to safely exit building and expectations of … Continued
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March 13, 2017
Ep042 Identify and Facilitate use of Infant and Child Car Seats
Important to ask about all allergies, not just medication allergies Some medications may have ingredients from different foods in their coating or capsules Must ask about allergies to IV dyes or contrast Ask about all food, environmental, and medication allergies … Continued
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March 13, 2017
Ep040: Define Performance Improvement and Quality Assurance Activities
Participate in performance improvement/quality improvement process Utilize research and other references for performance improvement actions Report identified patient care issues and problems (utilize chain of command) Evaluate the impact of performance improvement measures on patient care and resource utilization
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March 13, 2017
Ep041 Assess the need to refer patients for assistance with actual or potential problem
Examples of necessary referrals include therapy services (physical, occupational, speech), wound care, nutritional services, and so forth Recognize the need for referrals and obtain necessary orders Identify community resources for the client with health care team (Meals on Wheels, respite … Continued
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March 7, 2017
Ep039: Providing Care Within the Legal Scope of Practice
Know your state board of nursing Do not attempt to provide care outside of this scope – it is illegal Example: Texas Board of Nursing https://www.bon.texas.gov/practice_scope_of_practice_rn.asp
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January 6, 2017
Ep038 Report Unsafe Practice of Health Care Personnel and Intervene as Appropriate
Substance abuse/diversion Improper care Staffing practices
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4 min
January 4, 2017
Ep037 Report Patient Condition as Required by Law
Abuse and neglect Child, elderly, domestic Know your local reporting agencies (Child Protective Services) Communicable diseases Vaccine Adverse Event Reaction System (VAERS, vaers.hhs.gov) Report to Center for Disease Control (CDC) 2016 list of reportable conditions: https://wwwn.cdc.gov/nndss/conditions/notifiable/2016/ Adverse reactions to vaccinations … Continued
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5 min
January 2, 2017
Ep036 Review facility policy and state mandates prior to agreeing to serve as an interpreter for staff or primary health care providers
To be clinically appropriate medical interpreter, you must have appropriate credentials This is important because medical jargon is very different from fluency in a language, therefore competency and knowledge of specific medical jargon in various languages must be verified prior … Continued
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5 min
December 23, 2016
Ep035 Recognize Limitations of Self and Others and Seek Assistance
Be able to know when something is outside of your comfort zone High risk, low frequency procedures Know your chain of command for both clinical “how-to” situations and also administration issues Document appropriately
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5 min
December 21, 2016
Ep034 Identify and Manage the Patients Valuables According to Facility Policy
Most facilities have policies and procedures to properly secure valuables Ideally, valuables are given to family/friends to be taken home and secured If this is not possible, there should be a secured and locked location within the facility to keep … Continued
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6 min
December 19, 2016
Ep033 Identify and Educate About Legal Issues Affecting the Patient
Refusing treatment HCPOA disputes/living wills Mental illness and inability to sign own consents
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4 min
December 16, 2016
Ep032: Utilize Information Resources to Enhance the Care Provided to a Patient
This includes evidenced-based research, information technology, policies and procedures) Access data for client through online databases and journals Most hospitals have subscriptions to journals Professional organization journals have a plethora of information available, directly related to nursing Consistent review of … Continued
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5 min
December 12, 2016
Ep030 Receive and or Transcribe Health Care Provider Orders
Each facility may have a different process Identify inappropriate and/or unclear treatments or medications A nurse must administer treatments unless they believe they are inappropriate or unclear If this occurs, you must contact the prescriber and discuss further, document appropriately, … Continued
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5 min
November 23, 2016
Ep029: Obtaining Informed Consent
What is informed consent?  Basically the patient is giving permission for treatment and acknowledging that they understand the risks and benefits of the procedure as well as the consequences for not receiving the treatment. Wikipedia The patient must be an … Continued
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8 min
November 21, 2016
Ep028: Practice in a Manner Consistent with a Code of Ethics for Registered Nurses
Two codes of ethics for nurses Last updated 2015 First developed in 1953 Last updated 2012 The American Nurses Association Code of Ethics The Code of Ethics for Nurses (International Council of Nurses) Remember, these codes are not laws Different … Continued
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5 min
November 11, 2016
Ep024: Follow Up on Unresolved Patient Issues
Issues arise frequently that require the nurse to address them and ensure the problem has been resolved Examples Lab problems: unable to get serum sample, sample obtained hemolyzed, came to draw lab and patient at another test Nutrition issues: patient … Continued
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10 min
November 4, 2016
Ep021: Nursing Documentation
If it wasn’t documented, it wasn’t done!   Nurses are responsible for documenting many things. Some of which include: Care plans Medications (many facilities use barcode scanning) Nursing notes Assessments (focused, head to toe, vascular access devices, lines, tubes, … Continued
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9 min
November 2, 2016
Ep020: Provide and Recieve Report
Report will look different in various areas of the hospital ED report is very short and concise Critical care report is very detailed Floor report is more detailed than the ED, but less detailed than critical care Some facilities use … Continued
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9 min
October 28, 2016
Ep018: Maintain Patient Confidentiality and Privacy
Keep your password of EHR’s protected and confidential Don’t talk about sensitive information in public areas Speak with patient about which members of their support system they want involved in their care and identify anyone they may not want visiting … Continued
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6 min
October 26, 2016
Ep017: Assess Understanding of Confidentiality
Make sure the patient knows that their privacy is a priority to us It is one of their rights, it is not optional Intervene if necessary (episode 018)
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6 min
October 24, 2016
Ep016: Manage Conflict Among Patients and Staff
The nurse is at the bedside with the patient 24 hours/day and they typically feel most comfortable with their nursing staff.  Therefore, if a problem or personality conflict arises, the patient will most likely verbalize this to the nurse and … Continued
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10 min
October 21, 2016
Ep015: Identify Responsibilities of Each Health Care Team Member
Nursing staff Continual care provider, advocate, administer medications and orders placed by medical team, evaluate effectiveness, notify medical staff of concerns, facilitate collaboration of entire healthcare team, work with health care team to optimize care Manage additional nursing support staff, … Continued
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16 min
October 19, 2016
Ep014: Identify Responsibilities of Health Care Team
This needs to be done daily to ensure we are facilitating the appropriate plan of care As other members of the health care team assess the patient and develop plans and goals, we need to update our plans and goals, … Continued
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15 min
October 12, 2016
Ep011: Patient Rights: Discuss Treatment Options with Patient
Discuss treatment options with the health care team and make sure you understand them fully, then the physician (or support staff) will present to the patient The patient and their support system may have few questions when they hear the … Continued
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6 min
October 10, 2016
Ep010: Case Management: Initiate, Evaluate, and Update Plan of Care
Care plans / clinical pathways must be initiated upon admission and are complete at discharge Complete an initial evaluation to assess their current situation, read the notes from the health care team to understand what potential needs and realistic goals … Continued
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6 min
October 7, 2016
Ep009: Case Management – Ensure an Informed Discharge
The patient and their support system must have all information related to the discharge process as early on as possible Location, contact information (and contact info for after-hours situations), financial information, transportation, follow-up appointments, equipment (ensure understanding of proper use … Continued
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9 min
October 5, 2016
Ep008: Case Management – Plan Care Specific to Patient Needs
Consider diagnosis, prescribed treatment recommendations, ability to remain compliant, patient’s understanding of situation, support system available, ability to utilize resources when questions or concerns arise, affordability, level of self care Patient situations differ widely and it is not a “one … Continued
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12 min
October 3, 2016
Ep007: Case Management – Work to Provide Cost Effective Care
Consider cost when setting up care/resources Is this sustainable? How does their insurance coverage, Medicare, or Medicaid factor in? Do so in a non-judgemental way Speak with the patient and support system about finances, what they can realistically afford and … Continued
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9 min
September 28, 2016
Ep005: Case Management: Explore Resources to Maintain Independence
Become familiar with your community’s resources that can be helpful to patients attempting to maintain independence Nursing homes, respite care, SNF, home health agencies, Meals on Wheels Consider insurance coverage, Medicare, Medicaid, family support and availability to utilize resources
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8 min
September 26, 2016
Ep004: Identify Tasks for Delegation Base on Patient Needs
NCSBN Delegation | ANA: Developing Delegation Skills You will be responsible for delegating tasks to others; nursing assistants, other nurses, and so forth Not all tasks are appropriate to delegate You can only delegate tasks for which you are responsible … Continued
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11 min
September 16, 2016
Ep002: Advocating for Your Patient – What Does it Mean?
Advocating – help the patient and their support system understand the clinical picture and identified treatment options, identify their wants/needs, support the patient, speak on their behalf if needed, and uphold and protect their rights The foundation of being an … Continued
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11 min
September 16, 2016
Ep001: What Do Nurses Need to Know About Advanced Directives
It is the nurse’s job and part of the law (Client Self-Determination Act) to assess for existing advanced directives and integrate them into the patient’s care, and inform and educate about them if the patient is unfamiliar with advanced directives … Continued
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9 min
September 16, 2016
Ep000: Welcome to the Unofficial NCLEX® Prep Podcast for Nursing Students
Welcome to our brand new . . . hot off the presses podcast.  This podcast is designed to provide you with a step-by-step outline for the majority of the key points the NCSBN wants nursing students to know before taking … Continued
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27 min
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