How far do you go with precautions...

[massrn116]

We all know that gowning and gloving has become all too common place. Most recently in the ICU it has been decided for safe drug passing we are to bring our MAR charts into the patient room (they are paper in a plastic binder). We are told to gown and glove. Take a wipe, wipe down the bedside table(usually covered with patient's bedside personal effects)put down a chux, put the chart on it, administer the meds then take off our gloves, put on new gloves, wash down the chart, and then take off our gear. Any thoughts??? What do you do? Currently we take the chart outside the patient room, verify meds and then administer them.

[llg, PhD, RN]

OMG. That is overkill.

[cb_rn]

That really sounds extreme.

I know it would take forever to administer meds that way but I just had to do a culture on some common surfaces in my house. I wish you could see the agar plate from the handle on my fridge door! And I am EXTREMELY meticulous about wiping it down and not contaminating surfaces (food poisoning when I was first married). I'd be interested to see what kind of bugs would grow out if you cultured a patient chart.

[Forever Sunshine, ASN, RN]

I'd never finish my medpass if I did that.

[neutrophil]

That is an overkill, not to say that being cautious is wrong, but why not just do it like you do now. Leave the MAR outside. Sounds like more bureaucratic stuff. Never ends.

[ragingmomster, BSN, MSN, RN]

the wonderfully helpful folks in infection control suddenly decided last week that we are to wash our hands 5 times per pt visit.

before we go in the room

as soon as we get in the room so the patient can see

perform patient assessment

wash hands

don gloves

provide patient care

remove gloves

wash hands

leave room

wash hands

then if you have any skin left, start again for the next patient

[mamamerlee, LPN]

I just want to know when the admins will start screaming about the cost of the CHUX, and why it is taking you so long to do a simple med pass!!!

As for the handwashing - - I was recently a patient, and rarely saw people do a real wash - most just used the foam by the door.

I also commented to one of the docs who listened to my cardiac cath site (you know, the one in my groin) and then to my heart and lungs - and then proceeded to sling his 'scope around his neck. It easily touched the collar of his jacket, his shirt, and his tie. I told him I thought that doing that was really yucky. I am heavy and had to lift my panniculum for him to get to my site - sweaty, sticky. YUCKY. Where was his 'scope before he saw me? I made sure he wiped it down after he saw me!!!

[dscrn]

Wow! Going to be a problem with the number crunchers...

[cb_rn]

II also commented to one of the docs who listened to my cardiac cath site (you know, the one in my groin) and then to my heart and lungs - and then proceeded to sling his 'scope around his neck. It easily touched the collar of his jacket, his shirt, and his tie. I told him I thought that doing that was really yucky. I am heavy and had to lift my panniculum for him to get to my site - sweaty, sticky. YUCKY. Where was his 'scope before he saw me? I made sure he wiped it down after he saw me!!!

omg good for you.

I had a vascular surgeon come in the room once and start unwrapping a bloody dressing with his bare hands. that's a little too old school for me.

[vena cava]

i accidently brought the MAR in the room with me and a nurse corrected me that when the pt is on precautious you don't bring the MAR in.

[.MediKATE.]

At the hospital I've been a nursing assistant at for 5 years(just passed my boards yesterday) even the nursing assistant is supposed to bring the computer into the room to chart vital signs...however if the patient is on isolation the computer remains outside the room and once you exit the room and wash your hands you chart your vitals...same with RNs and medpassing..computer in the room with them to chart on the MAR unless they are isolation and then charting is outside the room.

[AggieNurse99, BSN, RN]

So as I was taught, with a paper MAR (as opposed to an eMAR), you must verify that the medical record number and account number are correct on each med pass. You do this by comparing the data on the MAR with the pt's ID band. This is to confirm 'right pt.' How do you do this without a MAR physically in the room?

If it's an eMAR where you scan the pt's ID band, that is also physically present, so you have a computer set up in each room? Wish my hospital had a budget - it'd be nice.