Cardiothoracic Nurse Evaluation

Goal three by the National Patient Safety Goal for 2014 is to use medicines safely. Many errors occur regularly with medications which is why communication is so important with the doctors, nurses and patients. One process that Joint Commission requires in accredited HCO’s is medication reconciliation “creating the most accurate list possible off all medications a patient is taking, including drug name, dosage, frequency, and route, and comparing that list against the physician’s admission, transfer, and/or discharge orders with the goal of providing correct medications to the patients at all transition points within the hospital (Finkelman & Kenner, 2012, p. 388)”. Ensuring medication reconciliation to the patient, health providers and any new consults that are

I feel so proud and yet so humbled to be a nurse. Helping a post-operative surgical patient regain the strength to walk brings me immense satisfaction. Collaborating with physicians to advocate on behalf of unstable patients makes me feel like a valued part of a team. Consoling tearful, discouraged patients can be gut-wrenching, but it teaches me the power of empathy. Making a real, tangible difference in my patients’ lives is what drives me toward this next phase in my career.

Being able to grasp the patient’s views, habits, and behaviors gives me the knowledge to assist the patient in making better choices. I have noticed in my workplace, how some nurses are better at conveying information to a patient and presenting it in a way that assist the patient in understanding the complexities of the issues. They do this with humor, challenging the patient’s reasoning, confidence, and solid examples of the matter. Observing these interactions has allowed me to intercede into my patient’s reasoning. There are times when I have been successful and moments when other nurses ask me to come and speak with their patient to assist in these difficult

Within the nursing profession, the role becomes more of an observer for vital signs, listener, and carer.

Before administration of any medication the patients chart should be looked at and varify that the patient has no allergies that could be related to said treatment or anything similar in their medical history. Also obtaining a baseline set of vitals prior to medication administration

rights, health, and safety of the patient.” This provision, identifying patients, medication safety are related because it is a nurse’s responsibility to protect the patient from harm and promote safety. Nurses are taught to use multiple checks before administering a drug and use two identifiers. These checks include checking the medication against the order when obtaining it, checking again when preparing the medication and the last check is done at the patient’s bedside prior to giving the medication. Also it is imperative to question any medication order that does not seem fit. The order should include a date, time, name of the medication, dosage strength, the route for

Any medication, for example, inhalers should be taken for those who may fall ill during the visit.

Also to give medication respecting the person’s dignity and choice, to only give authorised medication from a labelled container, to give the medication according to the training received. Also to help to inform and educate the person about their medicine should they wish to know, to be aware of common side effects. It’s also important to record episodes of care accurately, also to report any problems to the manager.

When it comes to listening it is one of the bullets for learning and becoming a great listener. Healthcare professionals gather all types of important information and that includes things that can be determined by forms or by just reading a chart. This is where active listening comes into correspondence and becomes a significant method of listening. Active listening is defined by listening with your undivided attention and by having a completely opened mind and being able to summarize the message accurately and clearly. Sometime listening can be overlooked and unrecognized as a key to ensuring all

Outcome measures assess whether the interventions to improve medication safety practice will be successful. During the interview of the new employee, competency evaluation related to medication administration will be applied first. In addition, during the orientation for these new employees, adequate training will be provided to ensure the importance of preventing medication errors. They will be given a list of similar and look-alike medications and will focus on medications that cause the most adverse reactions when errors may occur. Then, after training and when staff start working, they will be supervised during their first few months. When they are not supervised, they will be assessed and evaluated for any errors. During this process,

When patients are brought back for rooming, the nurse or medical office assistant will review the printed list with the patient prior to documenting in the EMR. During the office visit, we will review polypharmacy and are adding a document to our resources section of the EMR regarding polypharmacy and accurate medication list that will be given to all patients. I have always been aware of the importance of accurate medication list, but was not reviewing this often enough in our patients EMR.

“I try to place myself in my patients shoes and feel what each one is feeling,” says Prince. “Often patients tell me the work we do together help them find new ways to feel better. A tender moment with a patient sends a chill through me and reminds me why I love my job,” said Prince.

Accurate, comprehensive transfer of information about prescribed medicines across the healthcare interface is essential to ensure consistency between the treatment provided in hospital and in the community, and to ensure patient safety through the avoidance of medication-related inaccuracies. However, deficits in communication are widely reported.1-4 In 2009 a national survey of UK primary care General medical Practitioners (GPs) reported that they considered the information received on a discharge summary when a patient is transferred from secondary to primary care to be inadequate.5 They had particular concerns about discharge summary accuracy, timeliness and detail regarding medication changes. UK prescribing guidance, developed following extensive public consultation6 states that when patient care is transferred to the GP, secondary care doctors are obliged to provide details of the patient’s current and recent medicine use, medicine changes, length of intended treatment, monitoring requirements, and any new allergies or adverse reactions.7 Furthermore, in response to GPs raising concerns over receiving discharge information late, after the patient’s first post-discharge GP visit,8 a reduced timeframe of twenty-four hours after patient discharge for a discharge summary to be received in primary care was imposed from 2008.9

My passion for working in health care stems from my desire for trying to create a positive impact and difference in someone’s life. Who does this more in the health field than nurses? I have had the opportunity to work as an EMT, a Personal Care Assistant, and as a Nurse Assistant. In these roles, I would always witness nurses leading and being the first to create a relationship with a patient. Creating a relationship with a patient is what I enjoy immensely about working in medicine. When I would work as an EMT I would always try to create some kind of rapport with the patient to help them feel more at ease and to show them their concerns matter to me, even if it might not be a life-threatening emergency, it can easily feel that way to the

and worked within a multidisciplinary team (ACORN Competency 9). In my rapid assessment of the patient I met Competency 4: Conducts a perioperative nursing assessment of the patient (ACORN 2014). Bevan (2012) supports my diagnoses, saying that partial airway obstruction such as this is characterised by noisy breathing or a crowing noise. Pritchard (2009) supports my actions stating that once any degree of obstruction occurs measures must be swiftly taken to create and maintain a clear airway. Bevan (2012) describes airway management as the cornerstone of effective postoperative care in the PACU. In accordance with Competency 2 (ACORN 2004) I considered it ethically right for me to take over the management of the airway as I had more experience