njinformaticsrn

Does anyone work in a facility that uses an electronic scanning / electronic administration system for transfusing blood or blood products? I'm looking for info on something like an electronic MAR, but one specifically used for transfusing blood, where the unit(s) and a patient wristband are scanned, dual RN verification is done electronically, VS entered electronically, etc. Any feedback is welcome!

Has anyone found a good way to map lab results to LOINC codes? We are going to be undertaking this project for Meaningful Use. Some of the labs we send out to have been helpful in providing LOINCs, but to a large extent looking up the codes is a manual process. Any recommendations on what worked at your institutions? Many thanks for your feedback.

thank you all for the feedback- i appreciate the input

Thanks, rninformatics- yes, I'm looking into another way of addressing the flush rather than having it profiled as a med. Totally agree about the patient safety issue. We are currently trying to whittle away at our wristband scanning exception report which currently has several hundred items on it each day. The real problem is that there are no repercussions when someone does not scan the patient. How are such exceptions monitored at your institution?

Hi all- looking for feedback. Can you think of any scenarios in which it would be acceptable to NOT scan a patient's wristband in the contect of medication administration? For example, a flush is ordered q8h (these appear on our eMAR as a med) but IV fluids are running; therefore, there is no reason to administer the flush. Rather than bring the COW into the room and potentially disturb the patient, you would intentionally not scan the patient and then mark the flush as not given, providing the not given reason. Code situations could be a valid exception too. Thanks for your input.

Can someone please give me some advice? I had a patient today who had tremors, similar to Parkinson's. When the tech was trying to get the ECG there was a lot of artifact. I had been told by another ECG tech that in cases like this, it was ok to gently hold the patient's affected limbs- not applying a lot of pressure, but just gently pressing, as this might help control the tremors. He also gave me the tip that it is sometimes helpful for the patient to put their forearms behind their back and lay back on them (assuming arm leads were placed up by the shoulders). When I suggested this to the tech and nurse today, they told me that you should never touch the patient at all- as touching them in any way would throw off the result. However, as soon as I gently pressed on the patient's legs, the tremors stopped and the ECG was perfect- no artifact at all. Can anyone tell me if touching the patient affects the ECG? Many thanks in advance for the insight.

This helped me remember... If your R is far from P, then you have a 1st degree. Longer, longer, longer, drop...then you have a Wenckebach. If your Ps don't go through, then you have a Mobitz 2. If your Ps don't agree, then you have a 3rd degree.

I have practically zero- avoid cold things like water and "cooling" foods like cucumber and seek out "warming" foods- but I don't know what falls into these categories. I'm also interested in how much preparation goes into some of the foods, and if there are cultural practices around who prepares them. What can be done in the hospital to encourage cultural practices?

Hi everyone- I was hoping an OB specialist with expertise with Japanese patients could help me. Are there any dietary / nutritional customs, traditions, requirements, avoidances, etc during pregnancy and the postpartum period that are specific to Japanese women? My area does not have a large Japanese population and I wanted first-hand information rather than just relying on an internet search (you never know if the information you get is accurate). Many thanks for any help you can give!

thank you so much. that's exactly what my notes said! because i'm just starting out, i doubt myself too much.

but is the donut bad?

If anyone can help ASAP, I'd appreciate it. I'm a first year nursing student. We were told very definitively in class NOT to use a donut pillow when the patient has a pressure ulcer. Our instructors stressed this. A family member is currently in the hospital post-op for mitral valve replacement. He's 84 and has been in the hospital for 8 days. Yesterday we noticed a stage I pressure sore on his sacrum- today the area has a small fissure and a barrier cream was applied. When we visited, he was sitting on a donut pillow given to him by his nurse. Is this contraindicated? If the donut should not be used, what can we use in its place? Is an inflatable rectangular cushion ok? Thank you very much for your help.