Vicki_RN

Hi, We are updating our peds code blue process and I am collecting information on who responds to pediatric codes in other facilities. We are most interested in pediatric units in community hospitals, but happy to hear from all facilities. Does the ED physician respond? Thank you!

Hi! When pediatric patients are hospitalized post a self-harm event and waiting for transfer to a psych center, what measures are used for those patients at risk for elopement, after de-escalating interventions have been unsuccessful? What is the procedure for a minor running out of the room, that provides for the safety of the patient and staff? What role does hospital security play, if any? Thank you!

Hi, we are being asked to consider wearing gloves for all patient care activities on non-isolated patients, beyond just standard precautions. Does anybody use gloves for routine patient activities (vital signs, etc.) where no body fluid contact is likely to occur? We are looking for PICU practice, but input from any unit is appreciated. Thank you!

Hi Everyone, Does your hospital require RN insulin double checks for adult subcutaneous insulin? Our hospital is considering eliminating this practice, only for subcutaneous insulin. We use insulin pens for basal and rapid acting, not NPH or Regular. Thank you in advance for your responses!

Hi, my med/surg colleagues would like to know if any nurses go to the ED to pick up their patients to decrease transfer times to the door? Thank you!

Hi. We are revising our pediatric skin care guidelines and would appreciate hearing what others are doing. The adult area of the hospital requires a 2 person check for every single admission, regardless of the skin risk assessment score (adults use the Braden, Peds uses the Braden Q). I am wondering how many facilities do a 2 person check on every pediatric patient at admission, and if not, what is the policy for assessing pediatric patients? Thanks!

Thanks for the responses! Much appreciated. Yes...we are aware of the INS guidelines. We were just wondering if anybody out there was using midlines for that small percentage of patients that would be eligible within the INS guidelines. We heard rumors that the use of midlines was increasing in the community, but it does not sound like that is true. Take care.

Hi! Does anybody work at a facility that places midline catheters in pediatric patients and if so, what ages and by who? Thanks!

Hi, I am collecting data regarding the community standard for the use of a cardiac monitor, central or bedside, in the general pediatric hospital care areas. For those who work in a NON-ICU pediatric patient care floor, do you provide cardiac monitoring, is it central or just at the bedside, and which patients are considered for monitoring? I promise to post the numbers once I get replies for others who may be interested. Thank you for you help!

We are looking to purchase an MRI compatible IV pump that will accomodate our neonatal and pediatric patients. If a transfer of pumps is required, who transfers the infusions from the hospital pump to the MRI pump and back? Unit nurse? Radiology/MRI nurse? Any input regarding pumps or process are appreciated! Thanks!

:confused:for pacu's that care for pediatric patients: who transfers the pediatric pacu patient back to the unit? pacu nurse? peds nurse from the receiving unit? other licensed or unlicensed personnel? about how long is the transport trip from the pacu to the unit? our hospital is in the middle of a re-build, and the or/pacu will be about a 15 minute walk away from the unit. thanks for any information!

Thanks, Amyrae! Just the kind of input I'm looking for!:)

Hi, We are looking into a new IV pump/pump system for acute adult, adult ICU, OR, Peds, PICU and NICU at our hospital. Is anybody happy with their large volume infusion pump or pump system that is used in a variety of patient populations? I have reviewed the ECRI material on pump comparisons, but would like some real-life input. Thanks!

We were cited for having the Broselow tape in the ED, because we do not have it on the peds carts in rest of the pediatric areas of hospital, and they are looking for "standardization" among all of the peds code carts. Our ED only uses the tape for weight estimation... we don't use the other calculations on the tape. The state just didn't like us to have the tape on one cart, and not the others. We don't need it on the others, because we know the weight of the child in the inpatient areas. We are looking to other ED's to see which weight estimation system they use, if they don't use the Broselow tape (or if they only use the tape for weight estimation). Thanks!

Hi, For those in the ED who do not use the Broselow cart system, what method do you use to calculate pediatric weight for code meds? Do you use the 2X age + 4 method? Or 3X age +7? Do you use the Broselow tape for measurement of weight only, eventhough you do not use the Broselow cart system? We have been cited by the state for having a Broselow tape on the ED cart (we explained it was for weight determination only), because that is not the standard in the rest of the hospital. Thanks for any input.

Although it is from 2007, and the influenza needs to be updated (it's blank), the CDC has a document which states which isolation requiement is needed for each disease process. It is a long document, but it is in Appendix A, on page 95 of the document.

Thanks for the info. I have read the AABB's recommendations and it is the comment on the "Circular of Information" that I was curious about that states "...unless a) they have been approved for this use by the FDA or b) there is documentation available to show that the addition is safe and does not adversely affect the blood or component." Just wondering if anyone has found this "approval" or "documentation". Thanks.

Does anybody give any other medications simultaneously via the same IV when transfusing blood? The American Assoc of Blood Banks has a statement that says not to administer dextrose, lactated Ringer's or hypotonic saline simultaneously via the same IV as the transfusion, which leads one to believe that there are other solutions (i.e. antibiotics) that may be appropriate (otherwise, I think they would say that NO other solutions are allowed to be administered simultaneously). Just wondering if your transfusion policy allows for blood to be given with anything else via the same IV or lumen. Thanks!

What is your policy regarding the dressing requirments for the parents of pediatric patients in isolation? Do you require that the parents wear masks all day long when staying in the room with their children? The N95 masks now required for r/o H1N1are unbearable if worn for an entire day, and we are wondering how others are dealing with this. Thanks!

We are considering starting a PICC team. For those of you who have a PICC team, how is the patient charged for insertion of the line? Thanks!!

Thanks!! Just collecting some informal responses to present to our Infection Control Dept, who are dictating that the parents/visitors of these patients are not allowed to go to the cafeteria. I feel the same as the two replys. Thanks for the back-up!

What are your guidelines regarding parents/visitors of RSV patients going to the hospital cafeteria? Thanks!

Our hospital is asking us to go directly to insulin pens for our newly diagnosed peds diabetics, and getting rid of insulin vials (for pt safety). This would mean not teaching syringe/vial insulin inpatient anymore. Does anyone else have experience waiting until outpatient to teach syringe/vial method of injection for peds pts?

Thank you for the responses! It sounds like ACLS is not a concern of PICU's. If you have any other experience with this, let me know.

Quick question for all PICU's. Are the nurses in your PICU required to have PALS, ACLS, none, or both? Thanks!