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