Childrens+JACO+proceedures

**Proceedures and Policies**
brohciolitis clinical care guidelines
 * Nurse visits manual**

reviewed with mentor as they took the yearly test social work, red flag sexual assault, referals urgent care Orientation to unit rooms, open triage names on boards med count psych admit rapid psych flow sheet spych safety assessment flow sheet mental health hold watch suicide risk destructive behavior tox scren hosptial minors mental health hold patient rights read to pt clean UA suspected DKA knowne diabetse kushmal dec perip circ dec mental status monitor IV labs checkglucose VBG met panel US ketones, glucose
 * National patient safety guidelines**
 * Unit orientation info**
 * Nursing Quality Assurance Manual**

RN DC pull up specific are instruction forms, add MD instruction for discharge teaching

bronchiodialaotrs short acting albuterol nebulizers MDI metered dose Q 4 hours or less always use spacer this time Inhailed steroids beilomethasone decrease swelllling, not for quick relief MDI dry powder or nebb use becasue holds med ni chamber, 1-2 puffs 1-2x per day opti-chamber decreas watch number of coutns or lable or date so knwo when empt peak flow, cleaning equipment asthma asthma controler - steriod, for sustained control flare up levels green, yellow, red quick response form neb/inhailer, for urgent triggers early sx, couth wheeze, nebs to break tightness watch for breth walk,talk er tx, nail bed retractions fail meds less use of peak flow eliminate triggers smoking pollins molds household dust animals
 * Asthmatic pathway handouts**

Uint orientatino checklist review or safety manual bomb threat electricl probsl emergency evaucation - to outside court area osha rounds check floor for violations code response sheet bomb checmicl shower fire infant ablduciotn code pink mssing child > 6montsh med er blue violetn behavior flood influx of pts JACO epidemic evac mass causualty security toronado eye wasgh defective or unsafe equipment restricted access fire extinguiserh fire response o2 cylindars hasmat storage haz durgs haz spills has waste lser robavirin violence agresson weapons environmetn self asseemmsnt fire safety inspection checklist PASS drill safety update manual past docuemtns of evaluation
 * MSDS Safety Manual**


 * pt care guidelines**

ST cath infection fever and get UA foreign body ingestion infant less than 4 weeks septic work up for all

intranasal meds for pain, admin fent and versed for pain strep cx and rapid strep test oral nalsl suction oral rehydration

oncology pt with fever

scalp/facial lac

cicke=le cell fever sickle cellpain

pt with seizures Social Service - areas they can assist with or when to call:

CAP team on call all time > Ingestion
 * NAT call for non accidental trauma, abuse and neglect suspect
 * call for help with services and medications
 * Red flag parents/care givers who shop clinics for narcotics, flagged in pharmacies
 * Psych diagnosis
 * Serious life changing or threatening diagnosis
 * SIDS or near SIDS
 * Family issues
 * Legal issues
 * Trauma

Code Pink, Chidl abduction Position Inspect Notify Keep

call security

Network of Care Adm process fast track


 * MSDS**
 * Materials Safety**

Various Staff Shows how to demonstrate use of materials, safely

Nursing Quality Imporvement Manual Safety Goals PT ID - use photos, double check name bands, scans Care Give Connection Med SAfety Decrease risk of Infection Hosptial Educaiton Risk Patients

Quality and Patient care Safety Plan Hand Hygiene

Crash Carts Defibulator Check CPR certificaiton documenttat6ion CORE audits Medication HIPPA
 * Audits**

CEU Credits 3 moc cores 3 PD classes 1 Back to Basics Quarterly Competency Checks Quality CHEXComps Defib Check ER Certification OOICT Test BCLS recertificatino q 2 years PALS q 2 years TNC - ENPC TPD test adn mask fit yearly BLS assess online renewal program onlinetrainingplace.org Pals Cert ACLS find certification course
 * Education Notebook**

Cardiology Protocol for 12 lead ECG Influenza Vacine ENT Intake Tymp audiogram protocol orders Ear Rinse Insturmen/equipment cleaning Bio Med Yearly mask fit OSHA respitary hood/mask, fit and eval questions
 * EPIC for charting**
 * Planet TCH**

Loss of Power Med out of refirgerator to cooler Lights, emergency, flash and headlamps available Evac pals

QI Ppain PT Id, Photos, pt scan initial and post

Loss of Utilities Emergency manual Loss of public utilites Call nurse supervisor Zip line ELM Center ED Lutheran Pharmach

Monitor batteries Med gasses, med air

Computers system EPIC down paper forms for flowsheets,need to enter once live again Pt Education paperwork for DC also available on paper when down

MAR D/c allergy pt history problem list

STAFF TPD forms, OSHA respitaory mask

Joint Comission, Occurance reports safety training Hazardous materials identify adn safe uses Utilty failure fire respitarouy evacuation emergency management Equipemtn status
 * Emergency notebook**

CPE Cert Pediatric emergency certificate - get
 * Infection control**

Compressed gas cylindars Toranado safety plans Fire resp plan Infection contorl Fire insptctino check list Infection contorl Central line Target surveylence Ventilator Hemodialysis PHTN home infusions infection rate home cve infectino surveylance alcohol based assistance hadn wash health dpt reportable,emplopyee health reportables, BBP Pertussis, Health detp, pertussin. STD, menningitil

BD vacutaoner blood transfuer device reviewed CMT CA competencies for role delegation of tasks onlien policies Plante TCH undre CHEX system pain scales bier alien faces FLACC face lege activity cry consolability for babies to evaluate pain verbal 1-10 scale parents can also give this

DKA insuline perls rapid short long acting

blood sugar goals 6 yo 100-180 6-12 90-180 13-19 90-130 incraes mor oftenif kid ssick record results increase blood sugar hyper glycema cause skip insulin or infection not enough insulin physical emotional stress. high increase pee dry skin turger thrusty blurred vision tx adjust insulin, extra water 300 check keytones low blood sugar hypo glycemia increased activty skip meds or shots too much insulin other medications
 * diabetic treatmetn rsource binder**

hungery tired, shakey irratibel headache

glucagon for low blood sugar
 * Barbara Davis Center**

dka humalog fruity breath, \kushmal resp, icu dec gluc cerebral edema

ER coma decreased mental status, emergency <70-80 treat shakey sweat, clamy skin Neurology check IV Down time check in EMT intake ear plugs, edx testing ear sinus rinse, instruments cardiac Sleep clinick plumonary clinic influenza cvaccine GE clinic, gastrolabs, uroloty - instruments, Urine flow, bladder volume check Derm, pics aash funtgal punch biopsy wartstick, shave biopsy skin lession family plannign clinic important safety adn review idu setup remova med hs, lmp period copper T idu rehab surgical nurition ortho
 * Special Clinic Info**