ED Muskoka Physicians - Living the Dream

Archives for June 2017

Riita Cronkright

June 27, 2017 by Leave a Comment

Hi all,

Er nurse Riita in Bracebridge recently lost her husband…

Here is Nancy Andrews email…

Hello all,
I’m sad to let you know that Riitta’s husband Steve passed away this weekend. As most of you know, he had been sick for some time. There will be no service for him for now, but she is considering a celebration of life at a later date. In the mean time, we have started a collection envelope. It will be in the drawer with our personal files. Some ideas for use of the collection are a donation to a butterfly conservation charity, or perhaps, since Riitta appreciates tattoo art, to contribute to a memorial tattoo in Steve’s honour. Any other ideas are welcome.

Nancy Andrews, RN
Clinical Team Lead, ER
Muskoka Algonquin Healthcare
South Muskoka Memorial Hospital
(705) 645-4404
Ext. 3173

Please consider the environment before printing this e-mail message. This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the system manager. This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail.

Filed Under: Physicians Section

ET stabilizers

June 22, 2017 by Leave a Comment

We have ET stabilizers…
not all RT’s and staff are using regularly…

They are only $6 each so please use them every time.

We had a case recently that the ET tube was dislodged and patient arrested as this was trying to be fixed.

Filed Under: ED Administration

med histories

June 22, 2017 by Leave a Comment

Hi all,

Further feedback about this new trial of primary med histories and BPMH’s…..

1) Any issues with BPMH process send direct to Danette in pharmacy.
2) when admitting – if you know the meds are correct and feel you can order them – please do!
3) ed nurses or staff can do BPMH’s and can print you the forms as before if they have the two sources and the time – SO….USE those for admits if a BPMH is done.

AND…most importantly….

4) when admitting – in your handover – clearly tell the doc you admitting to what status the meds are in….then WE can never go wrong.

The delays created in not ordering meds is terrible ( I say this having been orphan doc last week). More staff is supposed to be coming on to do more of the BPMH work but still need to be hired!

Filed Under: ED Administration

Great Ultrasound Tips from Castlefest

June 18, 2017 by Leave a Comment

If you’re an ultrasound geek these tips are da bomb

click here

Filed Under: Education, Physicians Section, Ultrasound, Ultrasound

Updates from Antibiotic committee meeting

June 2, 2017 by Leave a Comment

Hi team

A few updates from the Antimicrobial stewardship committee meeting today. Exciting I know.
1. FYI – Peritoneal Dialysis patients presenting with ?SBP – there are NO nurses at MAHC authorized to access these PD catheters to obtain a sample (as per discussion with OSMH & RVH dialysis staff). Appropriate management includes a stat phone call to Nephrology to arrange for transfer for workup and management. Empiric antibiotic choices should be discussed with Nephro prior to transfer.
2. Several new ordersets have been drafted and are going to P&T, look out for these to be posted soon to Entrypoint. Hopefully they are helpful and less burdensome than that awful general sepsis orderset we used to have:
  1. 1) Endocarditis Order Set

    2) Meningitis Order Set
    3) Diabetic Foot Order Set
    4) Spontaneous Bacterial Peritonitis Order Set

    5) Acute Diverticulitis

    6) Necrotizing Soft Tissue Infection

    7) Febrile Neutropenia
    8) CDI Order Set and PR Administration of Vanco

There is also a document entitled:  “Intraabdominal Infections” that is NOT an orderset but provides useful evidence-based info on appropriate antibiotics to select. It will be posted to ENTRYPOINT to use as reference if you wish to access it when writing orders (or send your med students to find it to do some ‘self-study’ time!)
 
If there are other infection-related order sets you would like to see (or if you think a review of the literature is required on any current ones) please let me know and I can bring to committee!
 
 
Lastly, nothing to do with antibiotics, but if you weren’t at pharmacy rounds the other week an interesting tidbit of info that came up: Did you know that our hospital spent over $12 000 on the Zofran ODT wafers last year? If we had subbed every ODT dose for a PO dose we would have spent just over $600.  I forget the exact numbers but the PO dose is somewhere around $0.11 and ODT is over $2.00, IV dose is under $1.00. Interestingly, the ODT is NOT buccally absorbed, it just dissolves and then has to be swallowed and is absorbed in the GI tract just like the PO dose (still takes about 30min) – so my takeaway is that (except for in kids where swallowing a pill is an issue) if the patient can’t take PO, just give IV and skip the ODT!
 
Enough for today, enjoy your weekend everyone.
 
Kirsten
 
 
ps – yes, we are still waiting on baby to arrive!

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Filed Under: Home Posts Page