New nursing practices are transforming bedside care at Catholic Medical Center.New nursing practices, coupled with advances in technology, are enhancing beside care at Catholic Medical Center. From evidence-based care evidence-based care,
n a philosophy of treatment that relies on up-to-date, germane research as its foundation. guidelines and smart pump technology to a medication quiet zone and bedside glucose testing glucose test See 1 Glucose, see there 2 Glucose tolerance test, see there , new procedures are providing a heightened level of patient care and safety.
With each patient's medical records now stored and available electronically, CMC's nursing clinical documentation system incorporates evidence-based guidelines into the diagnosis and care of patients. When a patient is admitted to the hospital, the medical staff selects an evidence-based guideline based on the patient's diagnosis or diagnoses.
"This provides our nursing staff with a 'road map' or guideline for care" explains Elizabeth Hale Campoli, RN. "We treat each patient as an individual, but it is always best practice to have evidence-based guidelines to assist us with care and decision-making for our patients."
New technology is also assisting nurses in making good patient care decisions at the bedside. At CMC (Common Messaging Calls) A programming interface specified by the XAPIA as the standard messaging API for X.400 and other messaging systems. CMC is intended to provide a common API for applications that want to become mail enabled.
1. , nurses have been using a smart pump to ensure the delivery of accurate doses of prescribed medications.
Each smart pump is pre-configured with medications most frequently prescribed for patients and within dosing parameters determined by the pharmacy and therapeutics Pharmacy and Therapeutics is a committee at a hospital or an insurance plan that meets to decide which drugs will appear on that entity's drug formulary. The committee usually consists of both doctors and pharmacists. committee. Depending on the dosage amount selected by the nurse, the smart pump delivers the medication or provides a soft stop or hard stop caution. For example, if a physician ordered morphine morphine, principal derivative of opium, which is the juice in the unripe seed pods of the opium poppy, Papaver somniferum. It was first isolated from opium in 1803 by the German pharmacist F. W. A. at 4 milligrams an hour for a patient, but a nurse enters in 400 milligrams an hour, the smart pump delivers a hard stop and will not allow that level of dosing.
"With a soft stop, the smart pump asks me to recheck the order and review my patient's diagnosis to ensure that I do want to administer a dosage that is a little higher than normal" says Hale Campoli. "We require the nurse in this situation to have another nurse confirm the dosage and enter this into the machine. This is an excellent tool for ensuring patient safety."
The smart pump also allows patient profiles to be built into the system, so medications can be organized into groupings frequently used by specific patient populations. With CMC's recent association with the Norris Cotton Cancer Center NCCC is the comprehensive cancer center at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. It is New Hampshire's only National Cancer Institute designated comprehensive cancer center.
Mark A. , the hospital is treating an increased number of oncology patients and is developing an oncology-specific profile. When a nurse chooses the smart pump's oncology profile, only medications specific to this group of patients will be listed, reducing the potential for error in selecting the wrong medication Issuing of wrong medication is one of the major problems related to healthcare. It is the relatively high number of errors in the prescription of medication that occur. Errors with medication can occur in the doctor's office, at the pharmacy, in hospitals and even due to the . CMC smart pumps also include a neonatal neonatal /neo·na·tal/ (ne?o-nat´'l) pertaining to the first four weeks after birth.
Of or relating to the first 28 days of an infant's life. profile and a profile for high risk, lower volume patient populations.
Recognizing the critical importance of safe medication delivery, CMC is completing a medication quiet zone pilot program in the hospital's ICU ICU intensive care unit.
intensive care unit
see intensive care unit.
ICU and one of its medical surgical units. When nurses are in the posted medication quiet zone, they are not to be disturbed or interrupted unless one of their patients is in need of immediate care.
"We recognize that medication preparation and delivery is a sacred task that a nurse is performing and should not be interrupted" adds Hale Campoli. "Nurses have said they feel much safer in their medication preparation process in the medication quiet zone, and patients receive their medications more quickly:' The program will soon be rolled out hospital-wide.
Changes in point-of-care glucose testing are also transforming patient care. Because insulin is considered one of the five highest risk medications in the inpatient setting, and glucose results from bedside testing bedside test Lab medicine Any evaluation of analytes close to a Pt who may be a relatively critical state; devices used for BTs may be less accurate than those used in a hospital's laboratory, but have the advantage of short 'turn-around' time–eg, 2 minutes, would often be used to adjust insulin dosing, test limitations need to be eliminated to deliver the highest level of patient safety with the latest technologies.
CMC is completing a pilot program that includes a new glucose meter A glucose meter (or glucometer) is a medical device for determining the approximate concentration of glucose in the blood. It is a key element of home blood glucose monitoring (HBGM) by people with diabetes mellitus or with proneness to hypoglycemia. that will provide greater sensitivity of testing, reduction in risk of infection and elimination of interference by medications based on maltose, a type of sugar. The new meter connects electronically to CMC's laboratory information system, so patients' results are transmitted quickly and accurately to their medical record.
"By using this new meter we will be improving patient safety, testing sensitivity and information access" notes Roberta Provencal, a medical technologist This article or section may deal primarily with the U.S. and may not present a worldwide view. in CMC's lab.
For more information on these new nursing practices, contact ASK-A-NURSE at 603-626-2626.