October 2017


Effective October 10, 2017 - Midline Catheter Use - Physician Education Express

 

Midline Catheter is a short-term peripheral catheter (up to 29 days) for access to the venous system for selected intravenous therapy and blood sampling. Midlines are most commonly inserted in the upper arm and do not extend past the axilla. This peripheral access does not extend into the central venous system

Note: The midline is used as a peripheral line ONLY. It is NOT a central line or PICC.

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IMPORTANT: Cerner Enhancements Effective October 2, 2017

Effective October 2, 2017, the IS Uplift project is standardizing how specialties use Cerner. Please access the information below with links to videos and printable documentation (updates) to review important Cerner enhancements. This will affect the Uplift Standard Workflows, Dynamic Documentation and includes Discharge Medication Reconciliation Enhancements.

Please click here for more information regarding changes and enhancements impacting Inpatient and Outpatient Providers and Pharmistists Discharge Medication Reconciliation, Dynamic Documentation, and videos of Uplift Standard Workflow changes.


Delirium - Prevention & Management

Delirium is highly prevalent in our elderly patient population and treatment is vital.   This education will focus on identification of delirium risk factors, prevention of acute confusion onset, and treatment plan implementation to assist you in providing exceptional patient care.

  • Delirium is a disturbance of consciousness in which patients have a reduced ability to focus, sustain, or shift attention, along with a change in cognition or a perceptual disturbance, that is not better accounted for by dementia (American Psychiatric Association, 1994).
  • Delirium is highly prevalent, occurring in 70-80% of elderly hospitalized patients resulting in added cost to patients and healthcare systems.
  • Prevention is key to improve patient outcomes by identifying risk factors & preventing contributing factors.
  • Multicomponent interventions are needed to address cognitive impairment, sleep deprivation, immobility, sensory impairment and dehydration.
  • There are no pharmacologic interventions to treat delirium, making it necessary to look for organic pathways and de-prescribe as much as possible.

The Physician Education Express embedded in the link below will provide more detailed information regarding Delirium. 

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Mandatory IMMEDIATE POST-OPERATIVE or IMMEDIATE POST-OPERATIVE PROCEDURE NOTE Requirements

 

An immediate post-operative or immediate post-procedure note is a brief note that communicates pertinent patient information to the healthcare team until the full post-operative/procedure note can be completed. The note is to be completed immediately following any procedure (surgical and non-surgical) in which moderate sedation, deep sedation, or anesthesia services were administered. This requirement applies to procedures performed in outpatient or inpatient settings. Immediately following means PRIOR to the patient leaving the room (procedure or OR). Proceduralists accompanying the patient to an intensive care unit may complete the note in the new location but must indicate such in the note. 

 The required note fields include: 

  • Names of the primary surgeon or proceduralist and assistants
  • Post-operative diagnosis
  • Procedure(s) performed
  • Findings
  • Estimated blood loss  (if none, must list “none”)
  • Specimens removed (if none, must list “none”)

 For the note to be considered compliant by CMS, the above information must be present and the note signed, dated, and timed by the proceduralist in the timeframe listed in the above paragraph.  

 There are several PowerNote templates that meet all of the federally required documentation elements:

  • SN Immediate Post Op Note (may be used for anesthesia and/or sedation cases)
  • GI Immediate Post Procedure note
  • Cardiology/IR Immediate Post Procedure note
  • Abdominal Radiology Immediate Post Procedure note
  • Standard Immediate Post Procedure Note

The surgeon or proceduralist is responsible for completing the note.  Note completion may be delegated to a fellow, resident, PA-C, or NP assisting with the procedure.

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Don't Trust the Urine - A Quality Minute with Dr. Cole Beeler

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Quality Minute - Present on Admission (POA) Part I & II with Dr. Larry Stevens