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NUA 120 - Admissions, transfers, and Didcharges > NUA 120 - Isolation --> > Flashcards

NUA 120 - Isolation --> Flashcards

1
Q

Why are patients placed on isolation?

A

to prevent the spread of disease causing infection.

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2
Q

what are examples of infections that could cause isolation? (8)

A
  1. TB
  2. Salmonella
  3. AIDS
  4. Hepatitis A
  5. Draining boils
  6. MRSA
  7. Norwalk
  8. C. diff
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3
Q

as soon as the doctor has written an order for isolation what will the patient need?

A

to be separated from other patients

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4
Q

where is isolation information entered?

A

in meditech in the clinical data section

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5
Q

what are the different types of isolation?

A
  1. Enteric Isolation
  2. Respiratory Isolation
  3. Reverse Isolation
  4. Strict Isolation
  5. Wound and Skin Isolation
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6
Q

what are the precautions used depending on the type of isolation? (7)

A
  1. gowns
  2. gloves
  3. disposable dishes
  4. urine, stool, needle precautions
  5. hand washing
  6. masks
  7. double-bagging (equipment/garbage)
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7
Q

what is enteric isolation for?

A

for diseases transmitted by feces or urine (salmonella, C-diff)

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8
Q

what precautions must be used for enteric isolation? (3)

A
  1. gown must be worn if direct contact with the patient occurs
  2. gloves must be worn
  3. hands must be washed before entering the room and upon leaving
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9
Q

what is Respiratory Isolation for?

A

for diseases that are airborne (TB)

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10
Q

what precautions must be used for Respiratory Isolation? (4)

A
  1. door must be kept closed
  2. hands must be washed by everyone who enters the room
  3. masks are worn by everyone who enters the room
  4. all articles with respiratory secretions must be disinfected
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11
Q

what is Reverse Isolation for?

A

for protection of the patient from outside infection (burns, leukaemia, AIDS)

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12
Q

what precautions must be used for Reverse Isolation ? (3)

A
  1. the door to the private room must be kept closed
  2. hands are washed before entering and upon leaving the room.
  3. gowns, masks and gloves are when by everyone entering the room
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13
Q

what is Strict Isolation for?

A

for severe systematic infections (pneumonia and hepatitis)

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14
Q

what precautions must be used for Strict Isolation (4)

A
  1. door to the private room must be be kept closed
  2. hands must be washed on entering and leaving a room
  3. gowns, masks and gloves are worn by everyone entering the room
  4. articles that are not disposable must be wrapped and sent to central supply for sterilization
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15
Q

what is Wound and Skin Isolation for?

A

for infected wounds or skin infections (draining boils, MRSA, VRE)

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16
Q

what precautions must be used for Wound and Skin Isolation? (5)

A
  1. hands are washed on entering and leaving room
  2. gowns are worn
  3. masks, gloves and worn when having direct contact with the infected area
  4. techniques for changing the dressing are per each hospital policy
  5. instruments must be wrapped before being sent to central supply for sterilization
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17
Q

what are the NUA duties regarding isolation? (5)

A
  1. notify admitting for transferring the patient in the correct room setting.
  2. notify housekeeping of the room number and the type of isolation
  3. inform anyone involved in procedures ordered following the placement of the patient in isolation
  4. if porter services must transport the patient, be sure they know the type of isolation with which they will be involved
  5. note on the top of Kardex in the isolation space, the date and time of isolation
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18
Q

what are the steps of Off Isolation? (2)

A
  1. erase on the top of the Kardex and write date the patient went off isolation
  2. notify housekeeping so they can disinfect the room (terminal cleans)
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19
Q

where is a patients valuables kept for safekeeping?

A

in a safekeeping drawer on the ward

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20
Q

what is the NUA’s responsibility with patient valuables?

A

to put a patient label on the envelope

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21
Q

what are the 3 types of transfers that take place at the hospital?

A
  1. transfer to the nursing unit (transfer in)
  2. transfer out of the nursing unit (transfer out)
  3. transfer within the nursing unit (intra unit transfer)
22
Q

why would transfers from one unit onto another unit may be necessary ? (2)

A
  1. bed becomes available for an off-service patient on the appropriate ward
  2. patients condition may change and the type of care required may have cause for different facilities
23
Q

what are the reasons intra ward transfers would be necessary ? (4)

A
  1. to move the patient closer to the nurse’s station
  2. discharges may create several rooms with only 1 female so a female has to be moved in order to ave an available male bed
  3. two patients aren’t getting along and have to separate
    4 isolation requirement if a patient were to develop an infection
24
Q

for an intra transfer the patient is usually moved in what?

A

their bed along with the bedside table and any personal belongings

25
Q

what is the NUA’s responsibility prior to a patient Transfer In ?

A
  1. inform the charge nurse (PCC) and the assigned nurse of the transfer in
  2. check with assigned nurse to determine a time for her to receive the patient
  3. communicate with the other ward, when your bed will be ready (decide on and time)
26
Q

what will the admitting department inform the NUA when receiving a transfer in patient? (6)

A
  1. name
  2. disgnosis
  3. age
  4. attending physician(s)
  5. present nursing unit
  6. newly assigned bed
27
Q

what are the NUA’s responsibilities after the transfer in patient has arrived on the unit? (8)

A
  1. make assigned nurse aware of the patients arrival
  2. receive the patients chart from the transferring unit
  3. complete new chart label with correct info
  4. check the doctor’s orders sheet for any transfer orders
  5. place the old/thinned charts in the proper place
  6. record the patients name either on the ward clipboard, white or blackboard
  7. place the Kardex in the proper place according to the room number - erase the old room number and pencil in new one
  8. file the M.A.R.
28
Q

what do you need if the patient is being transferred to another nursing unit?

A

a written doctors order

29
Q

as the NUA you need to notify the charge nurse who will call the hospital supervisor with what info? (5)

A
  1. patients name
  2. room and bed number
  3. attending physician’s name
  4. disgnosis
  5. nursing service or unit the patient will be transferred to
30
Q

what do you record in the A.T.D. book when transferring a patient out? (3)

A
  1. patient’s name
  2. present room and bed number
  3. nursing unit, room and bed number the patient will be transferred to
    Eg. Doe, John, F6 Rm. 604-1 – E2 Room 202
31
Q

Report must be given by the RN to receiving floor before the patients leaves? T/F?

A

True

32
Q

what are the responsibilities of the NUA for transferring a patient out?

A
  1. Need Dr.s order to transfer out
  2. NUA must notify the charge nurse who will call the Hospital supervisor
  3. record in the A.T.D. book
  4. Report must be given by RN to receiving floor before patient leaves
  5. call the other nursing unit to make arrangements for the transfer
  6. page the porter to transport the patient when receiving unit is ready
  7. enter the “bed transfer complete” into Meditech when the patient leaves the unit.
33
Q

shortly before transferring a patient make sure the folling have been done: (7)

A
  1. be sure all orders are completed
  2. file all lab and diagnostic reports
  3. prepare the chart by either dissembling the forms from the binder or leave the forms in the binder
  4. have the old chart/ or thinned chart with the current chart so everything is together
  5. place Kardex and the beside chart with the current chart
  6. collect the MAR from the medication cart as well as the patients medications
  7. send all locked valuables/medicines to transferring floor
34
Q

NUA responsibilities for Intra ward transfer (7)

A
  1. enter transfer in the computer - bed transfer
  2. change the room and bed number on the chart
  3. relocate that chart in chart rack
  4. relocate Kardex
  5. enter transfer into ATD book
  6. move MAR or med cards to their proper place
  7. change the name of location on the clipboard, white or blackboard
35
Q

in order for a patient to be discharged there must always be?

A

a written order by the physician

eg. D/C tomorrow

36
Q

NUA responsibilities for Discharges (6)

A
  1. inform head or charge nurse and the assigned RN of the D/C
  2. record the discharge in the ATD book and on Kardex
  3. notify housekeeping
  4. ensure all discharged orders are transcribed
  5. send the old chart and thinned chart to health records
  6. duties once the patient has left the ward
37
Q

what are the steps after the patient has left the ward? (3)

A
  1. discard the Kardex and extra patient labels
  2. once RN signs the chart, dismantle the chart and put in health records basket
  3. enter data in the computer i.e. D/C complete
38
Q

NUA’s responsibilities for discharges to another health care facility (9)

A
  1. enter the transfer in the computer
  2. photocopy the patients chart
  3. call the non-emergency number to book an ambulance or median for transfer
  4. note the transfer time on the Kardex if patient is discharged for late date
  5. make sure photocopies and transfer form accompany the patient
  6. nurse needs to call the nursing home to give them a report
  7. complete that steps of a routine discharge
  8. be sure that the transfer/referral form is at the front of the chart
  9. enter discharge to facility into meditech
39
Q

NUA’s responsibilities for discharges against medical advice (AMA) (5)

A
  1. print a “waiver and release for patient self transfer”
  2. RN or LPN will witness the patients signature
  3. nurse will advise the patients doctor of them leaving
  4. enter the discharge in the computer once the patient has left
  5. proceed as for a routine discharge
40
Q

what is a Day Pass?

A

it if for patients well enough to go out of the hospital

41
Q

there must be a written order allowing a day pass by the physician ? T/F

A

True

42
Q

the day pass form must be signed when?

A

every time the patient leaves the hospital

43
Q

what are the NUA responsibilities for a Day Pass? (3)

A
  1. fill out the clerical parts of the form and place it in the front of the chart
  2. notify F.N.S. not to send a tray while patient is away
  3. card the order under the treatments or other section
44
Q

death is defined as?

A

cessation of heart - lung function, or of whole brain function, or of higher brain function

45
Q

how does the NUA help the staff when there has been a death?

A
  1. family - by taking them to a quiet area or room
  2. try to make the family comfortable until the RN or Doctor gets there
  3. the NUA can all the Pastor/Spiritual care or Social Worker to come to the unit
46
Q

NUA responsibilities regarding patients deaths?

A
  1. notify the nursing supervisor, admitting department and the nurse will call the doctor if they don’t know yet
  2. record the patients name, etc into ATD book
  3. enter the morgue slip and expiry into meditech
  4. notify housekeeping of when they can clean the room
  5. print and/or label forms
  6. when RN states patient is ready for the morgue, call porter to transport patient to morgue
  7. disassemble the chart in discharge order
47
Q

what is an Autopsy ?

A

highly specialized procedure that consists of a thorough exam of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present

48
Q

when is a Coroner called?

A

when there is any accidental deaths or suicide

49
Q

a Coroners autopsy is required by law if: (5)

A
  1. patient dies within 24 hours of being admitted
  2. suspected murder or suicide
  3. accidental death
  4. patient who dies within 24 hours of surgery
  5. patient who dies within 14 days of a transfer from community care facility
50
Q

Where do you find allergies?

A
  1. ADR
  2. Meditech
  3. MAR

NUA 120 - Admissions, transfers, and Didcharges (4 decks)

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