PLEASE:
USE – New sepsis orderset! ( its there and ready to use)
GI BlEED orderset as many have noted they didn’t know it existed!!
And always use orderset that fits with main diagnois of admission to trigger QBP care/etc.
THANKS
JOHN
Archives for January 2017
ACLS feb
January 21, 2017 by Leave a Comment
Hi all,
ACLS local in feb…
Sara Tumbar in Huntsville ER asked me to post this…
Spread to anyone you want.
John
admits
January 20, 2017 by Leave a Comment
Morning all,
Please ROUTINELY ask the charge nurse ( or bed allocator if daytime) if the site you are working in has beds when you go to admit.
It will save you phone calls/work if you need to admit to the other hospital site due to beds/services.
This has been a factor this week with gridlock at HDMH.
Then call switchboard at the site you are admitting to and ask for the orphan doc. The orphan systems are quite different at both sites so swithcboard is our coordinator/fallback!!
John
HDMH ER stocking reminder
January 19, 2017 by 1 Comment
Hi all –
In follow-up to our discussions at Journal Club tonight, I wanted to remind everyone of the following:
1. PROBLEM SOLVING for STOCKING ISSUES: There is a clipboard with ORANGE paper that leans up against the glass behind the ‘captain’s chair’ MD computer that is labelled “Physician – Missing and/or needed items”. This is intended to be a place you can jot down items you found were not stocked or missing while on shift (i.e. no dermabond in suture carts, missing cast supplies, where the heck is our otoscope…) This is meant to assist in communication with our nurses that do the stocking at night, and Sara Tumber can also review this every once in a while to try to fix some of the common/systemic issues that come up.
2. NEW CENTRAL LINE AND ART LINE KITS: Sara has created boxes to house supplies for central lines and art lines. These live on top of the carts in Trauma 1 and are very clearly labelled. Not sure if anyone has used them yet – if you do, any feedback on whether anything is missing? Central line kits should contain all the necessities including lidocaine, sterile syringes, caps, dressings, glove/gown/masks, and sterile U/S probe covers…. should help facilitate a quick and safe set-up in the future. Same idea for art lines (both femoral and radial should be stocked in the same box)
Also:
Keep your eye out for an email from me with a doodle poll in the next couple of days. Before our next business meeting I am hoping to put together some patient information handouts that can be kept on hand in the ER, and want your feedback on what topics would be most useful. (This goes for SMMH and HDMH docs)
Kirsten
carfentanyl
January 18, 2017 by Leave a Comment
Hi everyone,
As you will have seen in the circulated MAHC memo carfentanyl is confirmed in Grey Bruce and I am sure it is here too!!
Fentanyl testing is a send out test and has a two day turnaround. I ahem talked to lab about this within the last month.
Our current drug screen does not have like almost every hospital in Ontario and beyond.
Becky Vanersel ( our LHIN ED lead) had the following to add below…
“Only thing I want to make sure you know is that carfentanyl has been in grey bruce and likely will be in our lhin shortly. Decontaminate with cold water to reduce transdermal absorption for patient, high dose narcan (8-10mg) and consider narcan infusion. Full PPE is being recommended – but at least contact precautions for staff”
I am gonna reach out to Howard Ovens at Sunnybrook to see if he has advice and /or how they are approaching this….
Stay tuned.
John
choosing wisely
January 17, 2017 by Leave a Comment
Anyone have any topics that they find interesting in the “choosing wisely” campaign that they like and want to audit??
Track performance ? Or reasons we can’t/don’t follow it??
Take a read of the closing wisely ER section if you haven’t recently. No earth shattering things but…..interesting.
Please let me know if you are interested in pursuing something!
John
order sets
January 17, 2017 by 3 Comments
Hi All,
When writing orders for admission please always use the orderset having to do with the number one reason for admission!
I am currently auditing this.
Reason being…
1) QBP is being tracked and are built into order sets. Orderset use clearly triggers a cascade of things with need to be doing as a hospital that the ministry is tracking.
2) very soon…hospital funding is gonna be tied to performance on QBP practices.
This is brought up repeatedly at MAC now and re-discussed yesterday again.
I am happy to talk to anyone to explain more if needed.
thanks
John