PIPD Update July 26, 2024

Kudos

Kyle for being so diligent in reviewing the new CVAD Clinical Procedure! The Provincial Maternal Children group sends a THANK YOU for bringing questions and concerns forward! 

Danae for doing great when the coordinators are off!

Climber Cribs

* don't take them apart unless you are in an urgent or emergent situation. If a climber crib is not needed at the time, as the support staff to switch out the crib. 

H Drive Update

On Sunday July 28th, there is a H drive migration happening. 

What this means: 

*  You will have to manually sign out of the computer (no tap), hold the CTRL and ALT keys down and then press delete to manually sign out. 

            If you do not manually sign out, everything on your H:// drive (which includes your desktop) will be read-only mode.

 * After the migration, if you are experiencing issues with your desktop or H:// drive after manually sign out and logging back in, please call IT at 655-8200.

 CNE Updates 

AirTap - If you have a patient that could benefit from AirTap, they must meet specific criteria. You can find the specific criteria on the S-Drive 🠆 Pediatrics- Acute Care 🠆 Q-Cards - nursing 🠆 AirTap (folder) 🠆 "AirTap specific criteria decision tree PIPD" (PDF)

NEW Peds & Neonate CVAD - the new Clinical Procedure is now live. Heplock Guidelines are now in each Red IV Binder. A copy highlighting the changes is also in each Care Plan Binder. Heplocks are not a medical directive - "heplock per protocol" is not a Pharmacy accepted order. Please advocate for patient specific heplock orders.

Alteplase - RN given Line Occlusion Alteplase goes live August 1. You can only give Alteplase if:

    1) Were Certified at Ed Days Fall 2023 - please collect your certification record from the CNE mailbx outside Jon's office.
    2) Completed the NEW Pediatric & Neonate CVAD module on MyConnection - please sign the Certification Record at the sign-in desk.
    3) Refreshed your learning by the reading the NEW Clinical Procedure
    4) are Obs Trained

Blina & Dinu - coming again soon! Brush up on your Dinutuximab knowledge as there is a patient coming in the near future. The Binder is in the cupboard in Unit 3 Team Room. We will also be seeing more Blina patients moving forward. 

LPNs can give Immunizations if the following 4 steps have been completed: 

    1) MyConnection "Immunization Basics" module
        a) If you want to give COVID Vaccines, you must continually keep current with COVID training modules. 
    2) MyConnection "Anaphylaxis" module - this is to be done every year
    3) Signed the Certification Record at the sign-in desk
    4) Reviewed the q-card for giving Immunizations. It still requires 2 nurses to check vaccines.

Education Days - will be in October and November. Dates have not been released y scheduling yet.

BFI - JPCH has achieved the prestigious Silver Status on our journey towards becoming a Baby-Friendly designated Facility.
    What does Silver Status mean? - Commitment to evidence-based practices has led to successful implementation of 7 out of 10 BFI Standards. 
    This is exciting news! This achievement wouldn't be possible without all the work you, as part of the JPCH team members have done. Keep giving family centered care!

 

 Pharmacy Update 

There has been an increasing number of admissions where the "PIP" was not scanned in with the rest of the orders or scanned in after it is filled out.

In several of these admissions, home med doses were missed & not given as the "PIP" was not scanned/filled out. This is considered a med error. Posters are now hung in each unit to remind all staff and physicians about the "PIP".

Admission Med Rec (“PIP” form)

Did you look for an admission med rec?

· Medical team to fill out a med rec on admission to PIPD:

· Resident, attending physician, pharmacist, nurse can all fill it out

· If you are involved in admitting the patient, make sure the med rec is done!

· Meds “continued” on this form are an official order. All pages must be signed by prescriber!

· Review all new admissions to find this form

Exception: transfer from other hospital—no med rec form allowed

Bedside admitting nurse please scan to pharmacy!

This will ensure orders are processed, printed on the MAR, and medication is delivered to ward

Bedside nurse to transcribe all “PIP” meds on to first MAR

Missing med rec forms may cause missed doses or delays in therapy

 

PIPD Update July 19, 2024

Kudos

All staff July 17 Dx for their excellent Code Black response especially Jill, Crystal, Carolyn, Vanessa for organizing the team and preparations; Cheyenne for grabbing the EPP binder STAT; Sydney D for being ready to execute at any moment. 

Once we get some of our learning from the Code Black, and the planning that went into anticipating a possible Code Green, updated in the EPP binders we will let everyone know. 

Safety issues - recent events around body fluid exposure and an unanticipated medication exposure means that we need everyone to remember and apply the Point of Care Risk Assessment in their day to day work. Using a POCRA approach is about developing the habit of identifying risks and implementing mitigations for your self, be that medication preparation, working with blood and body fluids, TLR, infection prevention and control, patient and family interactions etc. Here is a guide for IPAC but these same principles can be applied to any situation IPAC-G-0010 Point of Care Risk Assessment (saskhealthauthority.ca)

Playroom toys - good news, we got access to stuff more properly organized with Child Life and Rec Therapy. 

• the giveaway cupboard is locked with a code lock now, only to be accessed by staff. Code is 3-2-2-5 'enter', and like the portable kanbans, needs to be entered again to lock it. Please do not share this with patients and families. 
• there will be a dedicated cupboard for toys that can be taken to patient rooms beside the giveaway cupboard. These can be taken out and then returned to the dirty toy bin in the playroom when done
• the other toys in the play room are to stay there and not be taken to patient rooms. We will soon have volunteers in the playroom at regular hours to supervise things, clean toys etc.

Applying for jobs - the new job posting site in MyConnection is more complicated to navigate than the former system. The quickest way of finding peds postings is by using the 'Hiring Manger' filter. For RN Nurse A positions (dept R270) you will need to enter Jonathan and for SEIU staff, RN Nurse B (dept R245) you will need to enter Fiona. Currently there are 7 postings for RN Nurse A. 

Short notice absence - a request if you are calling in for any short notice absence, we request that you submit it on-line and call the Charge Nurse. With delays in sick call processing in staff scheduling Charge Nurses are not getting a notice before shift change. But even prior to this our normal process was to also call the Charge Nurse, it works well for the team to plan around.

Pain Ease - please make sure Pain Ease containers make it back into Med rooms if the are not empty so that the next person can find it. We're very happy that we are using this so regularly, well done! Reminder that there are the other tools, especially for non-pharmacological distraction, on the Courage Cart kept in the unit 3 team room.  

CNE Updates

Acetylcysteine ALERT - you may see a new brand: hikma. Opening the vial is very different from the normal product. Instructions are on the S-Drive in q-cards and in the Red Medication Binders at each unit. There is a risk of the vial opening accidently if you don't follow the instructions and risk of being splashed with medication (eyes, arms, etc).

Always do a Point of Care Risk Assessment before any task to ensure you keep yourself safe from potential safety issues &/or injuries

Pediatric Central Venous Access Device (CVAD) Management changes Go-Live is July 23! FYI heplocking is changing - there are other changes as well! The Flushing/Locking Guide will be available in every Red IV Binder starting July 23. Please complete your eLearning then sign off on the Certification Record Folder at the sign-in desk. Pediatric & Neonate CVAD Learning

Alteplase - RN ability to administer Alteplase for Line Occlusion goes live August 1! You can only start doing this procedure if: 1) you were certified at Ed Days Fall 2023, 2) You have done the online Pediatric & Neonate CVAD eLearning on MyConnection Pediatric & Neonate CVAD Module , 3) read the new Clinical Procedure. Pediatric & Neonate CVAD Clinical Procedure, & 4) are Obs Trained.

Feeding bags - shortages are happening. You may see the double bag flush set or the 500mL size bag in kanbans. 

Interested in learning more about Autism care for ages 1-6 years? Its FREE. Each session has a different topic so you can choose which ones you want (or attend all). More information on topics & dates at the huddle board.

Register at: ECHO Autism SK - Series 2 FALL 2024 

New Feeding Pump for Patients on discharge: You will be seeing a new feeding pump for our patients being discharged with home feeds.  The Zevex Infinity pumps are easy to use.  Attached is a link for the video on how to operate the pump.  If you have a patient going home with a tube feed, please review this information.  This link will also live in the Q-cards under Feeding Pump Information.

https://youtu.be/mioZvO4_h7k?si=e39XZ5uOMntp05zC

PIPD Update July 12, 2024

Kudos

• Shania for working ++ hard with her DKA overnight
• Brenna for managing a sick kid in unit 4 so well!
• Unit 2 nurses for managing many sick admits and transfers July 4 Nx
• Ruth and Bunch for being so speedy with transfers and admits July 5 Nx
• Unit 2 nurses for handling a very busy unit and helping each other out July 5 Nx
• Leif for being a 10/10 resource nurse on very busy nights!
• Residents Caitlin and Devynn for managing a very busy unit so well!
• To all staff that helped July 6 and 7 Dx when UA/USW were very short

Job postings - the next batch of postings should be coming any day now via the new system in MyConnection. Since there is a backlog in postings we doing know exactly when they will show up and from what we've seen the new system is very different. If you are looking for a position please start to get familiar with the site now and start looking for our postings as we're not sure if we will get a notice of when they go up.  

Infection Prevention - we need to remind everyone about some recent misses and even though we're outside the viral season, diligence with IPAC practices is critical. This week 3 units in RUH are on COVID outbreak. 

• missed MRSA admission testing despite patient meeting criteria. This means screening wasn't done as it should be with every admission for every patient
• missed droplet/contact precautions for 2 days despite patient being symptomatic. 
• 2 hospital acquired cases (parainfluenza and rhinovirus) in unit 3 from the beginning of July. 

Hand washing, admission screening, PPE use, and enforcing precautions are required day-to-day activities for everyone. 

New Resource Material for Pediatrics: Check out this great online Educational resource for Pediatric Diagnosis and care.  This works best on a desktop computer.  See posters around the unit for the QR code.

SCM  - Lab work:  Did you know there is a drop down for Pediatric Common Diagnostic Specimens Order set?  Check it out next time you have an entire page of orders.

NEW PCA MORPHINE/DILUADID – Just a reminder that the Morphine and Dilaudid Bags for the CADD PCA’s are supplied by pharmacy, and in Pyxis.  We originally had sent a memo stating that the bag needs to be changed Q24H.  After more discussion with the committee and pharmacy team, we can continue with our previous process of PCA and Epidurals bags and change when empty.    Please Empty bags in the Cactus system, and document in Pyxis.  Information about the Morphine and Hydromorphone Bags for PCA use can be found in the PCA binders.

Cactus Narcotic Disposal System:  Please remember to only dispose medication liquid, pills, or patches.  A cactus was found to have medication packages as well as a glass vials in it.   Please use appropriately.  Questions, ask Tanzly or Cherie

CVAD – Please continue working on your Pediatric Central Venous Access Device e-learning on My Connection.  The new Central Line policy goes live July 23.  

N95 Fit testers - we are looking for people who want to be fit testers for the unit. This is a great opportunity for some worked hours for part-time staff. Please talk to Jon or Fiona about this.  Here are upcoming training dates: