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Medical Device Integration Blog

Batched Vitals

Posted by Halley Cooksey, RN on Jul 16, 2014 @ 09:00 AM


Nursing school…

Just hearing those words can make many of us cringe and flood us with a multitude of memories, whether it was studying the Krebs Cycle until 3 a.m. only to have to show up for clinicals at 7 a.m., or being convinced that you were going to be diagnosed with whatever disease process you were currently learning. All fond memories aside, nursing school was just that: school.

It gave me a foundation, but it didn’t give me the experience I was going to need to survive in the real world. We all talk about real world vs. textbook nursing. But it isn’t until you are on the floor – by yourself – that you really learn what being a nurse is all about and how to manage your time.

Time management is a critical component for any nurse to master. We must figure out how to be in six to eight patient rooms at nearly the same time and ensure we are providing personal, high quality, safe care. So, to “clone” ourselves, we learn to create shortcuts. Some of them are OK, but they often go against established hospital policy. One of the shortcuts I developed was “batched vitals”.

Batched vitals is a process I used when I would have a patient return from a procedure or who would require frequent vital signs monitoring. Knowing that I could not be in the room every 15 minutes, I would program the vitals machine to take measurements according to the doctor’s order and would promise myself to return and check on the patient, peek at the vitals, and then go on my way and repeat the process. Once I could steal away 15 uninterrupted minutes, I would wheel my computer in and manually enter the vitals in to the flow sheet from the vitals machine.

Is this shortcut safe? Have you ever “batched” your vitals?

I ask because I am truly curious as to what other nurses are doing. What is their real world practice as compared to textbook nursing? As a vendor who is out in the field, I get a lot of feedback from nurses and I have found that batched vitals seem to be a general practice. I am not saying that it is right or wrong (although I’m slightly comforted that I am not on an island of my own). But what I am asking is do we need to look at what the impact is on patient care by following this process?

I have read a few studies, but nothing says in bright red letters: “you must be at the bedside every 15 minutes”. But, if this is the case, does technology need to support real nursing practice and allow for sending validated batches of vitals? Or, should we continue with business as usual and embrace the adage of “we’ve always done it this way”?

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Tags: Medical Device Connectivity, Patient Care, Medical Device Integration, Patient Safety, Nurses, Nursing Stories, Vital Signs

The Face of Sepsis

Posted by Cyndi Coyne, RN on Jun 07, 2014 @ 10:00 AM

Sepsis is a truly devastating condition. As an ICU nurse, I have seen first-hand how it can ravage a body. I have cared for patients that, despite the best treatment and heroic measures, did not survive. It can appear, seemingly, from out of nowhere and can strike perfectly healthy individuals.

My first encounter with someone with sepsis was many years ago, as a medical assistant in family practice, before entering nursing school. I answered one of the hundreds of phone calls that came into the office daily. It was the father of a young woman; both were long-time patients that I knew them well. He didn’t sound particularly concerned and just went on to explain that his daughter had been having flu-like symptoms throughout the weekend.

At first, I accepted his “flu” assessment and began to give the usual instructions we tended to give patients with viral infections, but something in my gut told me this was something different. Instead, I told him to bring her in to the office so the doctor could see her in between his other scheduled patients.

When they arrived I could immediately see why I felt so uneasy earlier on the phone. She looked awful….very pale, extremely weak, not to mention confused. This was definitely more than just “the flu”. We escorted her into a room and while the nurse got her vital signs, I interrupted the physician who was seeing another patient. “We need you in room three,” I told him. He immediately went in to exam her and came out of the room a few minutes later and said, “Call an ambulance and get the ED physician on the phone for me.”  

After being transported to the hospital via EMS she was admitted with the diagnosis of sepsis. She spent several days in the ICU and for a while they thought she might lose her limbs, if she didn’t lose her life.

The cause was never determined.

Luckily, due to the skill, training and dedication of an entire treatment team of physicians, nurses, physical therapists, and more, she survived and without any residual symptoms. Sadly, though, there are so many who don’t.

The numbers tell us that every year millions develop and die from sepsis. It represents someone with a family and friends who love and care about them. They are your neighbor, your pastor, your sister, or your son.

Evidence links early intervention and treatment to better outcomes. Hours, even minutes, really count and can make the difference between full recovery and death. Advancements in early detection are being made through predictive analytics with the support of regulatory actions and sepsis-awareness community efforts. Healthcare organizations, such as North Shore-Long Island Jewish Health System, are seeing success with notable results of a 16.4% reduction in sepsis related mortalities as a result of modifying complex guidelines and metrics in the emergency departments.

Even those who survive can have life-long, debilitating effects including amputation of limbs, permanent organ damage, difficulties with cognition, and memory loss.  It is critical to provide tools to clinicians that will quickly and accurately identify sepsis in its earliest stages because it truly saves lives.

 

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Tags: Nurses, Nursing Stories, Clinical Analytics, Sepsis, Predictive Analytics

Growing Wings to Fly

Posted by Halley Cooksey, RN on Apr 09, 2014 @ 09:00 AM

I remember my first day “flying solo” as a nurse as if it were yesterday. I arrived 15 minutes early, my scrubs pristinely ironed, brand new sneakers, and even a brand new stethoscope. I was “dressed for success”, as they say.

I was scared out of my mind, but I figured that if I at least looked the part, no one would know that I had graduated from nursing school only 3 months before. I walked out onto the floor (did I mention it was an emergency department that typically sees around 70,000 patients a year?) and walked up to the charge nurse to receive my assignment. Her words were: “Don’t freak out, I am here to help you. You have rooms 2 through 5 and hallway beds 3, 4, and 5. None of the patients in the hallways have been triaged yet and all need to be registered”.  

I remember asking her if she was joking (not even Florence Nightingale could handle this type of assignment). However, true to her word, this woman, seeing the fear in my eyes, was by my side and encouraged me throughout my entire shift. She was never more than a few steps away. She was hands off enough to let me figure out how to organize things, but close enough to “gently suggest” when I may need to reprioritize.

When my shift was over, I was more exhausted than I had ever been in my life. My fancy, new sneakers looked like they had been run over by a semi and I’d lost my brand new stethoscope. Even with all of that, there was a silver lining. I was shown what it is to be a nurse: how to give selflessly not only to my patients, but to another nurse. And I was shown that a few positive words can make all the difference.

Finally, I was welcomed into nursing with open arms. I often think about that day and I have to tell you; had she not been there to support me, I don’t know if I would have made it. Instead of her “eating the young” as we say in nursing, she taught me how to use my “wings” to fly.

Was there someone there to encourage you? What have you done to encourage a new nurse?Every one of us has a story to tell about our first day on our own as a nurse.
Share yours!
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Tags: Nurses, Nursing Stories, Clinical

The Heart of the Matter

Posted by Karen Lund, RN BSN on Feb 14, 2014 @ 10:00 AM


On this Valentine’s Day, let’s get to the heart of the matter.  Every nurse has cared for that one patient they will never forget… a patient who has touched our heart or who we’ve touched literally and figuratively… a patient who has taught us a lesson, given us hope and has made us better a person. I’d like to tell you about one of mine.

My most memorable patient was a gentleman in our critical care unit with heart failure.  I’d taken care of him for a few days and had gotten to know him quite well.  One day, when I came on for my shift, he said to me: “I’m going to die today”.  Every nurse knows what that means.  He didn’t say, “I think I’m going to die today”. He knew. 

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Tags: Nursing Stories

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