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Assess IV cannula: Complete a VIP Score and Document

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Assess IV cannula: Complete a VIP Score and Document

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Rehearsal of IV Fluid Infusion and Administer IV Ondansetron Bolus

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Rehearsal of IV Fluid Infusion and Administer IV Ondansetron Bolus

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Work in Pairs: Graduate RN and Buddy Nurse

Use the ANSAT tool: Buddy RN to observe and add notes.

Image:https://www.sssaustralia.com.au/Images/ProductImages/Original/1487000_1.jpg

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For students playing the role of the Graduate RN:

You will check the medication and conduct three checks on the medication or infusion solution, verifying any calculations related to the medication or infusion and confirming the patient details with the patient.

Take this time to practice completing all the skills without coaching and to check your recall of what you know and to prepare for the CSSA.

For students playing the role of the Buddy RN (Observer):

Please observe the simulation and note areas where the student performed well and where they could improve.

Document how the Graduate RN completed the IV medication administration using the ANSAT tool.

You will share your feedback with the Graduate RN during the debrief session.

Please refrain from offering any prompts or suggestions throughout the simulation.

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Graduate RN and Senior RN working together to administer IV medications

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Guiseppe "Joe" Romano's 2-hour Postoperative Case Study

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Guiseppe "Joe" Romano's 2-hour Postoperative Case Study

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You are on clinical placement in the Surgical ward at Torrens Health. You have been assigned to care for:

I – Identification

Joe, a 62-year-old Italian-Australian male, who sustained a left femoral fracture following a fall and underwent left hip surgical repair (Open Reduction and Internal Fixation - ORIF) under general anaesthesia with a local nerve block.

S – Situation
Joe is 2 hours postoperative following left hip surgical repair and requires ongoing monitoring. He currently remains drowsy and responds to verbal.

B – Background

Joe sustained a left femur fracture following a fall associated with dizziness while walking his dog.

Relevant history includes:

Hypertension (recent antihypertensive ceased due to hypotension)

Osteoarthritis

He lives with his wife Isabella and is normally independent.

Postoperative Orders:

- Complete the postoperative observations, including the PQRST pain assessment and wound assessment

- Administer 1400 IV medication.

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Student 1: Play the role of the Graduate Nurse

Student 2: Play the role of the senior RN (observer)

1400hrs Postoperative Orders:

4-hourly neurovascular assessment.

Provide postoperative education.

Graduate RN:

1. Introduce yourself (Buddy RN plays the patient's voice) and complete an ID check using the MAR.

2. Perform a postoperative assessment.

3. Check PIVC - complete VIP score charting.

4. Administer 1400 - IV SSI Prophylaxis antibiotic.

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Buddy Nurse to evaluate the graduate nurse using the ANSAT Tool 

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Buddy Nurse to evaluate the graduate nurse using the ANSAT Tool 

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You can download and print this document to use during the CAP203 Labs and Extra Practice Sessions.

The observer (Buddy nurse) would check off the skills as the Graduate nurse performs them.

As a reminder, let the graduate nurse independently rehearse the skills without the observer's help.

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1130 Vital Signs and Neurovascular Score

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1130 Vital Signs and Neurovascular Score

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Vital Signs:

Resp: 16

O2 Sats: 98%

BP: 120/76

HR: 70

Temp: 37.1

AVPU: Verbal

Neurovascular Obs (upper limb)

Warmth: Warm

Cap refill: < 2 seconds

Radial Pulse: strong

Sensation: pins and needs

Movement: unable due to local block

Swelling: mild

Bleeding: small serosanguineous drainage present on dressing

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Standard-Adult-General-Observation-Chart - Joe Preop - 2 hrs postop

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What did we do well with each skill?

What do we need to practice more?

Did we maintain the aseptic field throughout preparation and administration?

Did we experience interruptions during the medication preparations phase?

How did we go about calculating infusion rates?

Were we able to complete the clinical documentation with ease?

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A Free flash online countdown, quick easy to use countdown timer! also an online stopwatch!

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Step 1: Part I: Nurse Introduction, Review Medication Orders and Complete ID Check

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Step 1: Part I: Nurse Introduction, Review Medication Orders and Complete ID Check

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Introduce yourself to the patient. Performing hand hygiene

Performing a Bed Safety/environment check as they are commencing their shift.

Review IV fluid orders.

Verify the patient's ID (name, DOB, and URN) and listen for the patient to state their name and DOB, comparing it to the patient's ID band and chart.

Explain the plan to the patient.

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Step 1: Part II: Look Up Medication, Gather Supplies for IV Fluids and IV Ondansetron, & Complete 1st 7 Rights + Med Check

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Step 1: Part II: Look Up Medication, Gather Supplies for IV Fluids and IV Ondansetron, & Complete 1st 7 Rights + Med Check

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Gather Supplies:

1. IV fluids (1 Litre of 0.9% NaCl)

2. IV Injection of Ondansetron 4mg/2mL

3. IV flush.

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Step 2: Prepare Medications & Complete 2nd 7 Rights + Med Check

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Step 2: Prepare Medications & Complete 2nd 7 Rights + Med Check

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*Look up Sodium Chloride 0.9% according to your local policy.

1. Look up IV Ondansetron in the eMIMS

2. Look up med in the Australian Injectable Handbook.

Check compatibility with 0.9% NaCl

Review administration

3. Complete 2nd 7 Rights + Med Check with RN for both IV fluids and IV Ondansetron.

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To reset your password, find the institution that issued your account.

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Step 3: Go to Patient Bedside: Provide Patient Education, 3rd 7 Rights + Med Check, ANTT, IV flush, & Administer IV Fluids + IV Medication

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Step 3: Go to Patient Bedside: Provide Patient Education, 3rd 7 Rights + Med Check, ANTT, IV flush, & Administer IV Fluids + IV Medication

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1. Explain the plan to the patient and provide patient education.

2. Complete 3rd 7 Rights and Med check with RN for both IV fluids and IV Ondansetron.

3. Set IV Pump rate according to the IV fluids order.

4. Perform ANTT:

Flush IV with 5 mL 0.9% NaCl to check for patency.

Administer IV Ondansetron

Flush IV with 5 mL 0.9% NaCl.

Start IV fluid infusion.

5. Document IV Ondansetron and IV fluids.

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Peripheral Intravenous Cannula Insertion & Maintenance Tool:  VIP Score 

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Peripheral Intravenous Cannula Insertion & Maintenance Tool:  VIP Score 

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Please see video regarding PIVC removal.

Please note that prior to removal any IV infusion should be ceased and the tubing disconnected from the PIVC.

Once the cannula has been removed -apply pressure over the site.

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Types of surgical wounds:

stoma

laceration

staples and sutures

covered in a surgical dressing or a cast

How does the nurse assess a wound that is covered in either a surgical dressing and/or cast?

What findings should we assess?

What are the signs and symptoms of infection?

When should we assess the wound?

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1. Signs of infection: erythema, oedema, exudate, malodour, warm to touch, elevated temperature, increased pain

2. Circulation – assess tissue viability - the tissue is alive and has adequate circulation.

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Understanding Flaps ( part 1 )in Reconstructive Surgery