PIPD Update March 28, 2024

Friendly Reminders

Call the charge nurse if you are going to be absent from a shift. Apply online lets staff scheduling know but then staff scheduling doesn't let charge know. It is difficult for Charge to make assignments if they don't know who is or isn't coming. 

Expired Chemo? 

Don't throw it out. Call pharmacy, they can fact check the expiry. Sometimes with handwritten dates they get the dates wrong and it can be costly to throw out a non-expired drug. So lets do our part and let pharmacy double check before we throw out the drug :)

Dear Health Care Worker

Immunization is an important component of the Staff Safety (OHS) program and it is a key strategy to prevent the spread of communicable diseases in a health care setting.

Recently there have been reports of measles outbreaks occurring worldwide, including in Canada. To ensure that our health care workers (HCWs) are protected from the measles virus, the occupational health nurses are actively reviewing HCW immunization records to determine if any HCWs are susceptible to the measles virus and require the measles vaccine.

As a HCW, you are at risk for contracting measles while at your work and/or spreading the disease to your patients, family and friends. It is important to protect yourself to keep others safe.

Measles - Key Points:

o Highly contagious respiratory virus

o Spread via the airborne route when an infected person breathes, coughs or sneezes

o The best way to prevent measles infection is to be vaccinated!

HCW Action Required:

 Contact your local Staff Safety (OHS) Office and speak to an Occupational Health Nurse to have your measles immunization status reviewed today.

SPH: (306) 655-5495 RUH: (306) 655-1387 SCH: (306) 655-8040

CNE updates

• Blair’s Retirement Book is in the small staff room for people to sign. If you would still like to come to an amazing evening out with delicious food and company, you can still join us at Crossmount. Email Cherie at cherieandben@sasktel.net with your RSVP & $53 for your ticket. Deadline – April 6.
• The 2023-24 seasonal influenza immunization program formally ends Sunday March 31, 2024. This is the last day to administer doses. However, as usual, and as noted in the Seasonal Influenza Immunization Policy, children younger than 9 years old who require a second influenza vaccine dose this season, remain eligible to receive their second dose up to and including Tuesday April 30, 2024.
• Adaptic & Adaptic Touch – both products are on backorder. If your patient needs this specific product, the substitute is the Mepitel One (one-sided wound contact layer dressing with silicone). Talk with the Wound Care nurse if this issue arises.

New Family Visiting Guidelines

Effective March 28, Visitors are welcome on the unit 8:00 am to 8:00 pm. Essential caregivers/family support persons are welcome at any time. A handout stating this is now included with all admission packages, so please ensure these are being passed to caregivers on every admission. 

Additionally, essential caregivers/family support persons limit activity within the unit between 8:00pm to 8:00 am.

• Each patient may have 2 essential support persons designated.
• Staff will ask that two persons be identified and documented on patient chart upon admission.

Essential Family/Support Persons are those whom:

• Participate in care decision-making.
• Serve as an essential partner on the care team.
• Are essential to the quality of life or care needs of the patient.

If visitors are disruptive to the patient's well-being, rest and/or recovery, or treating staff disrespectfully they will be asked to leave.

KUDOS

A full round of hi-5s to everyone on this week expertly dealing once again with massive inpatient volumes. Well done. 

All staff Mar 24 NX - Amazing work!

PIPD Update March 15, 2024

 KUDOS to everyone doing extra cleaning this week to keep us from going into an outbreak. 

We will need to keep in mind some lessons from this experience, as individuals and as a unit. More to come on that once we have good idea of where our vulnerabilities in process and practice are. But simply being in this situation prompts the need to make improvements. 

Calling Peds Residents at night

A reminder to please be cognizant of minimizing calling residents outside of urgent needs on Vocera at night during quiet hours between 2200-0600. Some real examples of calls that don't need to be made as one-offs over night:

• calling to ask if can give a PRN tylenol that was already ordered
• calling for a single temp of 36.4 in an unbundled well appearing infant
• calling to clarify orders that were written and added to the nursing care plan during the day shift but not calling until middle of the night
• calling to tell the resident that a child may need morphine for pain but not yet and they will call back if they do need it
• calling residents for teenage patients who did not void overnight
• calling for desats to 89% for 10 seconds with spontaneous recovery in an otherwise well child who has these previously (and other more subtle clinical vital sign changes that are still in the normal range but slightly different from daytime values)

What you can do:

- have a list of things ready for residents when they do tuck-in rounds and/or for first thing in the morning after 0600

- use your resource nurse and charge nurse for questions/troubleshooting

- batch calls to residents as much as possible if needing to call at night

CNE Updates

Measles – be familiar with signs and symptoms of measles. Measles (Rubeola) | SaskHealthAuthority

Be familiar with Infection Prevention and control measures (and need for airborne precautions). Meases IPAC Measures Algorithm (saskhealthauthority.ca)

Remember to take a thorough travel history for any patient with a fever &/or rash.

Q-cards

a.       NEW - Intramuscular Injection Sites – Under Q-cards-nursing -> IM-Intramuscular Injection SITES  (this is a new detailed, 2 page document with the different IM injection sites. It includes pictures and landmark information).

b.       UPDATED - IM-Intramuscular Injections INFO (this is where you find the preferred sites for age, needle length and gauge, and maximum volume per site).

c.       NEW - Dissolve-a-dose & hazardous medication. We are working on getting the new ENFit version into SHA. Please use PPE, the current Dissolve-a-dose, the white connector, and a ENFit syringe. Until then – see new Q-card: Dissolve-A-Dose.

3.       Kudos to all you cleaning Stars!!!

SHA Mentorship Program - The Saskatchewan Health Authority Mentorship Program is a voluntary program open to all employees and is ideal for:

- those who are new to the organization;

- existing employees taking on new roles; and

- mentors who want to share from lived experience and enhance leadership capabilities and communication skills.

The Mentorship Program aims to:

- improve the employee experience through relationship building and interactive workshops;

- develop employee leadership capabilities; and

- provide participants with necessary guidance and support to excel in their roles.

Details are available on the SHA site Mentorship Program | SaskHealthAuthority

If you are interested in being a mentor please let Jonathan or Fiona know. 

PIPD Update March 8, 2024

KUDOS

Travis for taking extra time and effort to help IPC clarify an new suspected HAI. Turned out is was community acquired. 

Preceptors needed - we need 5 RN preceptors asap for various placements May - Aug. 

SHA Transfusion Medicine Webpage - the site includes Transfusion Medicine Lab Blood Component and Product Monographs and provincial clinical resource materials, including nursing administration details

Discontinuing EFAP - This spring, the SHA will transition away from the previous LifeWorks Employee and Family Assistance Program (EFAP) and all staff will have access to TELUS Health - Total Mental Health Platform, a personalized and confidential wellbeing platform.

In order to maintain access and confidentiality, please check you have a current email address on Gateway Online. Ensure this address is not used between two or more active SHA employees. If the address is shared by more than one active employee, you will not receive the necessary emails to register when the platform launches.

System Flow Survey - Charge Nurses, please consider providing direct feedback on system flow processes via this survey - System Flow Coordination Center Deep Dive – Stakeholder Feedback Survey (smartsheet.com)

Staffing Scheduling posting needs - Charge Nurses, when calling staff scheduling to post RN needs Press 1 which should result in those needs being posted under R270. To post LPN, UA, USW needs Press 2 so they are posted under R245. For multiple needs this will mean that you will have make two separate calls which is annoying. We are working with staff scheduling to streamline this process.

New Equipment - 

- infant weigh scales x 4

- standing scale x 1 (more will come)

- Broda chair x 1 - for use by PIPD and PICU. Kept in PIPD basement cage. 

CNE Updates

• UPDATED Q-CARD: In “Q-cards – nursing” is an updated version of “Blood Products Monographs – How to access”. This is how you can find your information on Blood, Platelets, IVIG, Hepatitis B Vaccine, etc on the SHA site. NOTE: the information found on the SHR site is NOT UPDATED and will not be updated going forward. Please review the SHA intranet site for accurate information.
• From Transfusion Medicine: Please do not send the “return to transfusion” side of the tags to Health Records or Transfusion Medicine. Once the transfusion is complete, the tags that do not get attached to the transfusion record can be placed in the confidential shred box. If a patient has an adverse transfusion reaction, the Sask TAER form needs to be completed.
• Blair’s Retirement Supper is April 16 at Crossmount! Come for a wonderful evening of delicious food and great company. (see poster)

• Toothettes – have been removed from JPCH, RUH, SCH, SPH. We are working on a solution. Toothbrushes and toothpaste are in all clean supply carts (Units 1-4). Mouthwash has also been removed. If you are using a toothbrush on a patient, please rinse well and place upright in a cup/graduated cylinder to ensure it dries. Use a moistened toothbrush in place of a toothette. More details to come next week!

BiPAP & CPAP – there is a practice machine in the Unit 3 Team room. It has a laminated “Safety Checks for overnight” guide with lots of pictures on it. This is also on the S-Drive in a folder in Q-Cards-nursing -> BiPAP CPAP safety checks. Please play with the machine and read this guide. We are here for your questions and to walk you through using the machine. Please also ask RT for help and learning with your patients. There is also a Q-card in the S-Drive folder. The Q-Card states:

CPAP/BiPAP Patient Safety Checks - PIPD

SEE ONLINE Q-CARDS FOR CPAP/BiPAP PATIENT SAFETY CHECKS - PIPD

s-drive –> Q-cards Nursing –> CPAP/BiPAP Patient Safety Checks for overnight

The safety checks document is laminated and available to hang on each patient machine.  Located in RT cupboard (CN room).  If laminated version not available, print the patient safety checks document and hang at bed side.

·         It is standard practice to check on your patient and their machine Q1H

·         All patients with home CPAP/BiPAP must have an RT consult

·         Any questions or concerns, please contact Respiratory Therapy by Vocera, “Peds RT”

·         If Machine is alarming – Contact Peds RT

·         If caregiver sets up machine – RT or Nurse must check all settings

In the event of patient deterioration:

·         Assess: Device On, Oxygen On, Mask On

·         If deterioration continues, remove mask and resuscitate as required

(Nasal Cannula,  Non-Rebreather, BVM)

·         Increase Oxygen flow through device to stabilize SpO₂ if on previous O₂

·         Always Call RT, Resident/MRP/CN

IF ANY CHANGE IN HOME USE Ex. Extended time on, or NEW O₂ added = PICU CONSULT

Located on S-drive – Pediatrics – Pediatrics Acute Care- Q-Cards CPAP/BiPAP Patient Safety checks Q-card          March 2024

PIPD Update March 1, 2024

KUDOS 

Feb 24th NX shift- Great work on handling lots of admits while balancing high acuity

Denae for her excellent Q15 min BP for HOURS

Harper for coming in short notice to help admit 2 HA pts

Leif for always volunteering to take admissions

Allie and nursing student for acting fast and being awesome

Helen for getting us some new infant swings!!!

Briana T for excellent family centered care

Great work everyone, the team work has been amazing to see. 

Maurice Ahmeecheko’s grandmother, Catherine, has asked us to extend her appreciation to all the JPCH teams who have looked after Maurice over the years. She is grateful for everything that has been done for him up to his passing last week and very much wanted individuals from all areas to know this because as she put it “everyone knew Maurice”.

EMS coverage brochure - FYI (accessible via SHA website) CS-PIER-0148 Saskatchewan Ambulance Fee Brochure (saskhealthauthority.ca)

High Acuity (Obs) working group - we're looking to set-up a working group including staff to talk about and work through High Acuity issues like model of care, location, criteria etc. Timeline is TBD but time commitment would be regular meetings for a moderate length of time. We are looking for 3-4 staff so if you are interested and foresee yourself being available to participate please email Jonathan and Fiona. 

CNE UPDATE

1.       There is a new Q-card: it is for Urine STI collection. Go to Q-cards nursing folder and look at the Urine Specimen Collection folder. You can also search for any of these words it will pop up: “urine” “STI” “NAAT” “Collection”.

2.       Ferrous Fumerate oral suspension is on back order. Ferrous Sulfate (oral suspension and tabs) is also still available.

3.       MARs – you must write 4 digits to show time of administration. For example: you give the med at 09 scheduled time, write 0900. If a med is NOT given, you can circle the 2 digit “09”, initial and write reason it wasn’t given. Keep putting in 1600 calls as you can provide evidence of safety concerns!

4.       Cumulative dosing (for PCAs) – please write the 4 digits to show when you’ve checked the cumulative dose.

6mL ENFit syringes – purple ones are out of stock. Currently you will see an orange & white 6mL syringe. There have been concerns about meds getting stuck when drawing up/administering with these substituted syringes. Stores is aware and we are looking at what options we can do.