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The ED at Mercy Medical Center in Cedar Rapids, IA, had to be moved to another floor on July 13, as flood waters filled the hospital's lower levels. Despite having to uproot patients and equipment, the ED remained in constant contact with internal and external resources due to the presence of redundant communications options.
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As the effective response of the ED at Mercy Medical Center in Cedar Rapids, IA, to the recent floods demonstrates, the extra dollars required to invest in top-notch communications systems are well worth it, according to Rich Head, director of information services.
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Overcrowding, higher-acuity patients being held in hallways, and The Joint Commission's new National Patient Safety Goals (NPSGs) for 2009: It's the "perfect storm" to put hospital-acquired infections on the top of any ED nurse's priority list.
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Here are three steps to take to prevent hospital-acquired infections in your ED:
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Make sure staff wash their hands consistently. It sounds simple enough, and it's necessary to comply with The Joint Commission's National Patient Safety Goal to prevent deadly health care-associated infections due to multiple drug-resistant organisms. But it's anything but easy for most EDs to do this.
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A patient involved in a motor vehicle accident was alert with stable vital signs when he arrived at an ED. Three hours later, a nurse from the step-down unit came to transfer the patient for continued monitoring. She saw that he no longer was opening his eyes and didn't respond to verbal commands.
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ED nurses at the University of California Medical Center Irvine use a protocol for handoffs that involves giving verbal reports to the accepting unit using the SBAR (Situation-Background-Assessment-Recommendation) format. Sanna K. Henzi, RN, MSN, trauma injury prevention coordinator, gives this example of an incomplete report:
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Do all pediatric asthma patients receive relievers, corticosteroids, and a home management plan in your ED? These are three measures of care for which The Joint Commission is collecting data.
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When a woman came to the ED at Christiana Care Health System in Wilmington, DE, complaining of nausea, vomiting, and diarrhea, she was initially triaged as low acuity. "But when the ED nurse saw how uncomfortable the patient was, she decided to do an EKG on her," says Kelly Powers, RN, an ED nurse at the hospital.
