PIPD Update April 25, 2025

 LPN Scope of Practice - an updated LPN Practice & Scope for PIPD guide has been placed into the S-dive and Charge Nurse binder. This is to guide safe practice and care for patients on PIPD while working within scope.

RN Scope of Practice - A new RN Practice & Scope for PIPD guide has been created and placed into the S-Drive and Charge Nurse Binder. This is to guide safe practice and care for patients on PIPD while working within scope for all levels of RNs. A detailed understanding of our RN levels and staffing/assignment goals are also on this guide. We hope it helps clarify what skills RN can do within each level of training. 

    Care Clarification for RN scope - care of Transplant patients and Hazardous medications (oral, IV) are part of the Oncology trained RN scope (Level 2). This was a decision made in partnership with Management (PIPD, Oncology), Oncology, Oncology Clinical Coordinators, CNEs, and Physicians. It is similar to care provided on 6100.

Please see email re: RNSP revisions from Sharon sent April 23,2025

CNE Update

Feeding Pumps - the Kangaroo Omni will be live as of Tuesday April 29. A practice pump is in the Unit 3 Team Room to play with until Monday, April 28. All our current pumps will be switched out by Clinical Engineering on April 29. This means any in use pumps will be swapped out too - more details to come the morning of April 29!

    Feeding pump learning - we have quite a few Super Users who attended the in-person in-service for our new pumps! The pumps are also very easy to use. Once you have reviewed the practice pump or this video & sheet (included in this blog & in the Certification folder), please initial by your name for the Certification Folder. *Those who did the in-person in-service April 15 & 17: you can just initial that training was complete.  

Please contact a CNE if you have any questions!

Feeding Bags - our current regular Kangaroo pump tubing has already been removed from our in-room kanbans by SPD in preparation of the new tubing going live April 29. A box of our regular tubing is in the Unit 3 Team Room. 

    ***Until the change to the new pump & tubing, ALWAYS check for a replacement bag before throwing away your current feeding bag. If we cannot find more tubing, we are to rinse the bag and tubing with warm water, remove the left-over water from the bag and "prime" until all water has been removed from the tubing.*** (we are hoping we have enough and this won't need to be done)/

Changes to SMOF infusion - Starting May 7, Pharmacy will be sending a Lipid filter in the bag of SMOF. With changing evidence, using a filter with SMOF or Lipid emulsions is now best practice. 

    It is indicated for the removal of particulate debris, microbial contaminants, and entrained air that            may be found in solutions intended for IV administration. It provides patient protection against

    particulate contamination, oversized lipid droplets, microorganisms and air.

Gtubes - any new Gtube surgery needs to have the Gtube Nurse consulted. Even if this patient had a prior Gtube and this was a new site/new sized tube. Consulting the Gtube Nurse will ensure the family gets the prescription for supplies needed prior to discharge. 
    Remember, if the Gtube falls out and it has been less than 8 weeks since surgery (2 months), call the surgeon! Do not reinsert the tube.
    If the Gtube has been more than 8 weeks post op, you can reinsert the same Gtube if intact or insert a replacement long shaft (located in Walmart). Ensure Gtube Nurse is aware if you had to replace the Gtube.
    If it is a PGJ that has fallen out, insert a replacment long shaft (located in Walmart) and notify the team. A Surgeon will need to be consulted if they are not the MRP already.

Nebulized medications UPDATE - Supply of both salbutamol nebs and Combivent (salbutamol + ipratropium neds) are replenished. Normal use may resume.