PIPD Update March 27, 2025

Peer FIT testing

Next dates for fit testing on the ward:

April 15/25 0930-1400

April 28/25 1930-2300

May 8/25 0930-1400

May 13/25 1930-2300

Measles

There is a work standard for placing suspected measles cases on the ward. The key point is these patients NEED to be in the negative pressure rooms (2301 and 2305). Having them in a regular room with the door closed and an air scrubber is NOT sufficient. If the patient is needing obs level of care we will need to adjust staffing to provide that level of care in those rooms, not move the patient to obs.

There is a copy of the work standard and the posters for the entrances in the charge nurse binder under M.

CNE Update 

Info tip of the Week - did you know that there are many pre-made discharge information sheets on the S-Drive? This includes information for you, the nurse, to teach on discharge and information for families on caring for their child after discharge! 

Check out the S-Drive: Pediatrics-Acute Care 🠆 Discharge and pt information (folder)

We would love to know what is missing for teaching families - send your ideas to us and we will reach out to physicians and the Outpatient Nurse Coordinators for that specialty.

PIPD Update March 21, 2025

Med Room Doors

Pharmacy has found med rooms to have tape over the latch to allow opening the door without a prox card. Please do not do this. The meds rooms are proxed for safety and accreditation and cannot be propped open or have the locking mechanism disabled. If there are issues with the prox entry to the med rooms please have an urgent req put in for maintenance. If you are having issues with you prox card please see security services.

Cultural Responsiveness Training
This mandatory module needs to be completed by all staff by March 31^st. It can be found on My Connection.
My Connection > My Learning > Access My Learning > Search All Modules > Cultural Responsiveness > Introduction to Cultural Responsiveness

Measles

There has been a confirmed case of measles in the province. Some staff would have had their childhood immunizations in the time were 1 MMR vaccination was considered fully vaccinated. In 1989 the national recommendations changed and now 2 doses of MMR are required to be considered fully immunized and protected. This is a good time to check your own immunization status with OH&S.

Additional dates for FIT testing of N95 masks on the ward are being confirmed. More info coming.

There is a measles toolkit on the Intranet and on the S Drive under Q-cards-nursing with information about signs and symptoms of measles and resources for what to do. Please review: IPAC Algorithm Management Suspect Confirmed Measles. A work standard is coming for suspected measles patient placement guidelines.

Short notice trades/LOAs

Trades and LOAs need to be approved through staff scheduling/manager. It is very difficult to ensure safe staffing when it only done by word of mouth (ie me telling the charge nurse that someone else is working my shift tomorrow). If there are issues having things approved in a timely manner through staff scheduling let Gail/Manager know and that can be addressed with staff scheduling. The charge nurse is not expected to approve these leaves.

Annual Vacation for Employees on Leave of Absence

Ø  PIPD Team, please see below from the Sr Scheduler. Should you have any further questions re: your annual vacation, please send these to Gail and the covering manager (Lynette, Fiona, or Lori), so we can direct your questions to the Sr scheduler and follow up as needed: 

"I’m currently entering approved vacation into schedules of the Leave of Absence employee’s, even though they haven’t returned to their rotations yet. Any approved shifts or blocks will be recorded so they appear correctly once the employee is back in rotation. Given the size of the group, I’m updating the calendar monthly.

 At this point, I believe all approved vacation through the end of June has been entered for employees on leave. I will continue working through the remaining updates. 

Please note that with the new Annual Vacation process, employees no longer receive approval or denial emails. Once Scheduling has processed requests, we notify the unit managers."

 

 CNE Updates 

Salbutamol nebs - remain in limited supply. Availability is expected to improve over the next few weeks. MDI supply remains stable.

Oral Chemotherapy medications - must be given by a Chemotherapy Certified RN. Even if it is for a non-chemo patient (Policy section: 2.1). Precuations are to be followed the same as IV chemotherapy (Policy section: 2.6, section 3.2.4 - 3.2.7 & section 3.4). Please review Policy - SHR - Chemotherapy Drugs (oral) for Cancer and Non-Cancer Treatment: Administration & Precautions

PIPD Update Mar 16, 2025

Manager coverage update - in addition to Gail acting as unit Supervisor the following will be out or scope managers supporting the unit. 

Mar 17-21 Lynette Koroscil

Mar 24-28 Fiona Raes

Mar 31-Apr 4 Lori Bjorkman

Apr 7-11 Fiona Raes

April 14 -18 Lori Bjorkman

RN Annual vacation for those on leave - if you are on an LOA and have not received a notice about approved annual vacation by Mar 18 please reach out to our HRBP Jenna Boivin at Jenna.Boivin@saskhealthauthority.ca 

Nursing preceptors - thanks to those who have stepped up. But we need 4 more. Talk to Gail if you can help. 

Xray Progress Note in patient chart - Charts are to go with the patient to the X-ray department. When the X-ray is complete, the technologist will either stamp the progess note in the chart to indicate the Xray has been completed. Please ensure the chart is sent down to Xray.

Starbucks RUH closing - After more than 20 years, Starbucks is closing at 8pm March 31:
"We are anticipating the announcement of the new vendor later this Spring with renovations soon underway to create the perfect space for our new vendor.
But don’t worry, we are committed to keeping our coffee-loving community fueled with delicious options! That’s why Nutrition and Food Services is brewing up something new to bring you even more variety in specialty coffee and espresso. Starting April 1, we will be serving up locally sourced coffee, espresso, and baked goods at a pop-up coffee station near the previous kiosk until the new vendor is ready to open.
Please stay tuned for more information. Rest assured that there is a lot percolating and we can’t wait to spill the beans on what’s next." 

        - memo from the Director of Nutrition and Food Services - Retail, Production & Procurement

Cefoxitin - 1g vials are on backorder. The 2g vials still remain on backorder. Physicians will need to choose an alternative antibiotic therapy once remaining 1g vial stock is depleted.

Learner placement unit preceptor draw

In April 2024, the Learner Placement Unit (LPU) implemented a monthly draw for preceptor education. Each month, names are drawn for $250 gift cards. SHA staff are eligible upon completion of a preceptor education module, preceptor workshop attendance, or engagement in preceptor education activities. The deadline to enter is March 31, 2025. 

“The monthly draw is a great incentive for preceptors and the learning modules are spilt up nicely," said Teaghan Munro, Radiology Technologist-CT, Prince Albert. "This allows you to choose the ones that are relevant to your own position as a preceptor.” 

“I appreciate the checklist resources available from the Preceptor Education Program (PEP)," Said Wendy Villers, Sonographer, Saskatoon. "I completed the course out of curiosity and interest, and for a chance to be drawn for a gift card is a nice finishing touch to the whole experience.” 

Please visit SHA Learner Placement Unit or contact SHAStudentPlacements@saskhealthauthority.ca for more information. 

CNE Updates

Blina - PIPD and the Outpatient Onc unit are trialing an updated Equashield. This version of Equashield provides a better attachment of the Equashield to the tubing and Equashield to the patient's clave, preventing any accidental detachments. This means you will not need to tape the male Equashield to the Female Equashield. There is a March Blina Memo in the Blina Binder with pictures.

NAS & ESC - Neonatal Abstinence Syndrome (NAS) is a diagnosis that is "scored" using Eat Sleep Console (ESC) if the infant is under 1 month of age. If an order says to do NAS Scoring, please clarify with the physician that they would like Eat Sleep Console. If the infant/child is over 1 month of age, we use WAT. Both ESC and WAT are on Forms on Demand.

Transfusions - From April 1- 30, Transfusion Medicine is requesting staff to also fax the physician orders for any Blood Product or Blood Component with the Transfusion Medicine request form (ex: PRBC, Platelets, IVIG, etc). Transfusion Medicine is conducting audits. We appreciate your support in ensuring the order is also faxed with your request form.

Vocera - Please clean Vocera badges with the Accel (Intervention) wipes. This aligns with Infection Prevention and Control's updated guidelines based on information from the manufacturer.

Monographs - Phosphate Sodium has been updated to include pediatric monitoring and the use of a 0.22 micron filter.

OxyMasks - Should not be used with the bubble humidifier. During the patient's inhalation, room air containing humidity is drawn in through the mask openings and mixed with the wall oxygen flow. In speaking with the RT Educator, there is a potential safety issue if you use a humidifier when the oxygen requirements exceed 6LPM. 

Updates to the Transmission Based Precautions Table - Infection Prevention and Control (IPAC) has updated the general principles of the TransmissionBased Precautions Table to remind clinicians (e.g., physicians and nurses) of the requirement under the SaskatchewanPublic Health Act to report all suspected or confirmed category one and category two communicable diseases, such as measles, to their local Medical Health Officer (MHO) within 48 hours.

Clinicians do not need to wait for lab confirmation to initiate follow up. Staff can refer to AppendixA of the Saskatchewan Communicable Disease Control Manual for a listing of all Category one or two diseases. 

Remembering Max

Max's Funeral is Monday March 17 at 1pm - see link for more information https://www.grantfuneralhome.com/obituary/Max-Threinen

PIPD Update Mar 7, 2025

PIPD Manager Coverage

In order to facilitate consistent support of the unit Gail Fox has agreed to step into the role of Temporary Supervisor. This assignment is meant to provide coverage Monday to Friday when a first line out-of-scope supervisor (i.e. Manager) is absent, such as during our management change. In this role Gail will function as an extension of one of the covering Managers and as such will oversee the unit operations, bringing in a manager when it is required. She will therefore be in charge of the unit however this will not include all manager functions such as HR/LR, payroll, and approving purchases. Gail will be in this role starting March 17 to April 30, 2025, Monday to Friday 0730-1600. The following will be manager coverage to support Gail and the unit:

Mar 10, 14 - Jonathan

Mar 11, 12, 13 - Fiona Raes

Mar 17-21 Lynette Koroscil

Mar 24-28 Fiona Raes

Mar 31-Apr 4 Lori Bjorkman

Apr 7-11 Jonathan

April 11 - on TBA

Please support Gail in this role. As of Mar 17 Gail can be reached using Jonathan's office phone (306-655-2059) and cell phone (306-514-8839). 

Managing Risk

Standard practices minimize the risk of harm when they are done consistently and used whenever indicated. Failure to do them or doing them inconsistently increases risk, which depending on what that practice is, can impact patients and staff. It is difficult to always appreciate this fact when risk is rare or when any one of us never sees or rarely sees the negative consequence. This leads to underappreciating a risk and/or thinking the standard practice isn't valuable. There is no reasonable excuse for safety event happening if failing to follow a standard practices results in preventable risk occurring. And certainly the quest to manage all safety risks in the system for everyone is an ongoing thing. Fortunately, we do not see a lot of risks materializing into harm, with the glaring exception of hospital acquired infections. However, on a number of fronts we are practicing in such a way that we are introducing a high degree of potential risk because of inconsistent standard practices. Some examples of note from recent events:

- ensuring safety checks are actually completed fully - when suction is found to be incorrectly set-up this indicates a safety check was missed. Risk - unable to urgently manage and airway. 

- treating IV fluids more like a medication than food, including accurate documentation as well as labeling and checking expiry dates. For example,  whenever you have a metabolic patient there needs to be extra diligence with measuring and monitoring all intake (PO, IV etc.) and output, including ensuring food and fluids provided by family are recorded. You also need to assume all IV fluid administration, These conditions also require time sensitive IV fluid replacement, lab work and medication admin that can be more sensitive that with many other patients. If you are ever unsure of these details, discuss with the medical team and detail in the care plan. Risk - over or under dosing fluid replacement, electrolyte (and for some metabolic patients pH) imbalances, secondary renal issues etc. 

- medication safety - we still regularly see medication errors happening where no MAR was taken to the the bedside and a true independent double check isn't happening. Risk - we see the wrong patient getting the wrong medication, wrong dose, at the wrong time. 

- Infection Control screening - 5 HAI cases have been attributed to admission on our unit (2MRSA, 2VRE, and 1 Inf A). You are all aware of the standard practices that are required at all times in order to prevent this from happening including p[patient and family screening, 4 moments of hand hygiene, signage and updating SCM, diligent PPE, terminal cleans before precautions are removed. A recent audit shows there is room to improve, starting with the basics of compliance with ARO and symptom screening . 

Risk - patients (especially immune compromised) with Hospital Acquired Infections from common viruses to CPO that increases care needs, increases their length of stay etc. 

CNE Updates

Epidural - If you are needing an Epidural or PCA key out of Pyxis remember that you now need type 5 letters in the override.

• Epidural Key is now PCEA_(one space of the keyboard at the end of PCEA)
• PCA Key is PCA_K (a space inbetween the A and K)
• CODE YELLOW:  MISSING PCEA KEY FROM UNIT 2.  Please check your laundry, backpacks and pockets and return ASAP.

Airway box conversion is complete.  All rooms will now have a pediatric & adult NRB hanging from the side of the airway box.  Any feedback, please let Cherie know.  Thanks to Resh for her help in completing this project.

Dissolve a dose is not available.  To replace this, we will be using the Rx Crush bag (see picture).  These bags will be used for dissolving our hazardous medications for safe delivery.  They will be stored in the CN room for now until more supplies can be brought in.  Any questions, ask Pharmacy or a CNE.

Ostomy and Wound Team

The RUH wound care team has reorganized their coverage now that they have 4 fulltime nurses. 

CELL 1 – Chelsey	5000 (Units 3, 4 & OBS), 5100, 5200, 6300, AMB CARE
CELL 2  - Domini	5000 (Unit 1 & 2), 6200, ICU, CCU, DUBE
CELL 6 – Jody	5300, 6000, ER, MEDICINE 3000, MIU, STOMA CLINIC
CELL 7 - Kelly	PAC, SURGE 3100, 4th TCU, 6100, JPCH, POPD

Getting to work