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The Art Of Giving Report

July 1st, 2011 | Posted in The Nurse | 4,693 Comments

Have you ever left after a shift and realized you forgot to relay some important piece of information to the next nurse? It can be tough to organize and prioritize your communication in a timely manner. A structured format or even the use of a template can be helpful; however experience definitely plays a role here too. Like anything else, giving report to an oncoming shift or during any patient hand-off takes practice. A common acronym used to ensure an organized and thorough report is SBAR: Situation, Background, Assessment, and Recommendation.

When I first heard of this method, it seemed too short for me. How could 4 letters/headings be used to convey all the information about my patients after a 12-hour shift? As I learned a little more about SBAR, I realized it was not much different from the method of report I had been using for years.

S= Situation. Include admitting diagnosis, history of present illness, events of hospitalization (Tip: for patients with long hospitalizations, a timeline of events is helpful.) Also, what is the patient’s current situation? Include review of vital signs and events from the past 24 hours.

B= Background. Past medical history, past surgical history, family history, psychosocial history.

A= Assessment. Review of systems. My preferred method of organization has always been neurologic, respiratory, cardiovascular, gastrointestinal, genitourinary, hematologic/immunologic, and endocrine systems; skin; laboratory values and diagnostic findings; medications; psychosocial issues.

R= Recommendation. Include anything that needs ongoing or further attention.

What method of report works best for you?

 

 

8 rights of medication administration

June 26th, 2011 | Posted in The Nurse | 2,091 Comments

Please follow these rights

Chances are that some of you may not have known that in addition to the well-known 5 right of medication administration, some experts have added 3 more to the list.When it comes to patient safety, it’s never a bad time to review some of the basics and increase your awareness of newer recommendations. Please add any of your own tips and medication safety advice by leaving a comment. Thanks!

Rights of Medication Administration

1. Right patient

  • Check the name on the order and the patient.
  • Use 2 identifiers.
  • Ask patient to identify himself/herself.
  • When available, use technology (for example, bar-code system).

2. Right medication

  • Check the medication label.
  • Check the order.

3. Right dose

  • Check the order.
  • Confirm appropriateness of the dose using a current drug reference.
  • If necessary, calculate the dose and have another nurse calculate the dose as well.

4. Right route

  • Again, check the order and appropriateness of the route ordered.
  • Confirm that the patient can take or receive the medication by the ordered route.

5. Right time

  • Check the frequency of the ordered medication.
  • Double-check that you are giving the ordered dose at the correct time.
  • Confirm when the last dose was given.

6. Right documentation

  • Document administration AFTER giving the ordered medication.
  • Chart the time, route, and any other specific information as necessary. For example, the site of an injection or any laboratory value or vital sign that needed to be checked before giving the drug.

7. Right reason

  • Confirm the rationale for the ordered medication.  What is the patient’s history? Why is he/she taking this medication?
  • Revisit the reasons for long-term medication use.

8. Right response

  • Make sure that the drug led to the desired effect.  If an antihypertensive was given, has his/her blood pressure improved? Does the patient verbalize improvement in depression while on an antidepressant?
  • Be sure to document your monitoring of the patient  and any other nursing interventions that are applicable.

 

Lisa Bonsall, MSN, RN, CRNP

 

5 tips to help new nurses and nursing students survive

June 18th, 2011 | Posted in The Nurse | 2,715 Comments

This is a time of year when many new nurses enter the workforce. Learn from the mistakes of those I’ve watched…and from the mistakes of the new graduate I used to be!

 

1. Channel your inner boy scout. Always be prepared with the following essential items: A black pen, a pair of bandage or trauma shears, a stethoscope, a calculator and a watch.

2. Take care of yourself. If you are a spazz in your off time, you will be the same at work. Drink lots of water, get plenty of rest and do something FUN and RELAXING on your days off.

3. Don’t ever call a patient by their first name unless they give you permission. Also, don’t call people Honey, Dear, Sweetie, etc. You never know who you might offend.

4. Listen three times as much as you talk. It will keep you from experiencing foot in mouth syndrome.

5. Watch how other nurses do things and pick what works for you. Ask lots of questions and find out whose style you admire and whose style you don’t.

 

 

Barbados Health Care denied to visitors

June 6th, 2011 | Posted in External Affairs | 2,758 Comments

BRIDGETOWN, Barbados, Wednesday April 20, 2011 – Health Minister Donville Inniss is fighting a battle both at home and in the regional arena over a government policy that prevents non-nationals who are not citizens or permanent residents from accessing diagnostic, clinical and pharmaceutical services at public medical facilities.

While he has had to address Guyana’s Health Minister’s criticism of the decision, Inniss is also facing some level of resistance from local doctors who say that while they will follow the directive, they will be treating all patients equally.

The Barbados Association of Medical Practitioners (BAMP) has said its members will not be checking to see whether non-nationals who seek health care have regularized their status.

But, speaking at a press briefing, Minister Inniss responded: “We never asked them [the doctors] to do that in the first place. I don’t think it’s their duty. We haven’t sought to add any additional responsibility onto doctors.”

He said the task of screening will continue to be handled by medical records clerks at the polyclinics and the Queen Elizabeth Hospital.

The minister said he had spoken to BAMP President Dr. Carlos Chase to clarify the situation.

Inniss insisted that his task was to find solutions that would redound to the benefit of citizens and health care access is no exception.

“There are several instances where some people have been residing here in Barbados for an inordinate length of time [and] have not had their status regularized,” he said.

“I am not a cruel and inhumane Minister. I hear these complaints every day. I have spoken with the Chief Immigration Officer, I have spoken with the Minister with responsibility for immigration as recently as (Monday), and I am satisfied that as a Government we will work together to ensure that all of those who are rightfully entitled to anything in Barbados will get what they are entitled to. We just need to ensure that the processes are followed.”

Inniss also addressed criticism of the policy by Guyana’s Health Minister Dr. Leslie Ramsammy at last week’s meeting of the Caribbean Community (CARICOM) Council for Human and Social Services (COHSOD).

The host minister, who is also COSHOD Chairman, had said that the decision was worrying and suggested that regional governments provide free health care to all CARICOM nationals.

Inniss said he did not expect any fallout in Barbados’ relationship with Guyana over the issue.

“Minister Ramsammy made his comments. I, in response, on the margins of the meeting would have spoken with him and enlightened him. I think there was a misinterpretation of what he would have read in the newspapers…but what is important to me is that the people of the Caribbean are able to love each other as brothers and sisters and that we are treated with a great level of hospitality when we visit each other’s nations,” Minister Inniss said.

“I am of the opinion that we as Ministers can have our differences of opinion, but I am also satisfied that whilst politicians talk and shout at each other, the ordinary citizens of the Caribbean are living the true CARICOM experience,” he added.

Read more: http://www.caribbean360.com/index.php/news/barbados_news/362334.html#ixzz1OW6z1D00

 

 

History of SLNA

April 14th, 2011 | Posted in SLNA | 2,270 Comments

SLNA was establish 1947 and was registered as a professional organization in 1949. In 1975, SLNA gained bargaining rights when it became a registered Trade Union with its objectives being to protect and defend the rights of nurses. In 1976 SLNA got international recognition when it became a member of the International Council of Nursing (ICN).

SLNA was establish 1947 and was registered as a professional organization in 1949. In 1975, SLNA gained bargaining rights when it became a registered Trade Union with its objectives being to protect and defend the rights of nurses. In 1976 SLNA got international recognition when it became a member of the International Council of Nursing (ICN).

SLNA was establish 1947 and was registered as a professional organization in 1949. In 1975, SLNA gained bargaining rights when it became a registered Trade Union with its objectives being to protect and defend the rights of nurses. In 1976 SLNA got international recognition when it became a member of the International Council of Nursing (ICN).

SLNA was establish 1947 and was registered as a professional organization in 1949. In 1975, SLNA gained bargaining rights when it became a registered Trade Union with its objectives being to protect and defend the rights of nurses. In 1976 SLNA got international recognition when it became a member of the International Council of Nursing (ICN).

SLNA was establish 1947 and was registered as a professional organization in 1949. In 1975, SLNA gained bargaining rights when it became a registered Trade Union with its objectives being to protect and defend the rights of nurses. In 1976 SLNA got international recognition when it became a member of the International Council of Nursing (ICN).