# data[].attributes.body
The thoracic team is conducting a research study to identify tumor markers via blood draw on POD 1.

It entails drawing an extra blood tube (provided by the thoracic team) on POD 1.

Reach out to Laura or to 11 Center Charge if questions come up.

# data[].attributes.attachment_link.title
AlloSure Lung Specimen Collection Tip Sheet

# data[].attributes.body
Some sternotomy cart supplies are not in CDR and are specialty order. Supply is in Frances's office. Please communicate when items are needed for the cart:

Sutures

Epicardial wires

Temp pacer extension wires

Sorin dilators

Decanters

Auto suture surgiclips

# data[].attributes.body
In response to recent patient safety events, the Cath Lab is implementing an updated patient weight guideline for procedures.

Effective immediately, the maximum patient weight that can be safely accommodated with Cath Lab equipment is 450 pounds. This change is being made to ensure the safety of our patients and staff, and to maintain safe operating limits for our procedural equipment.

To better support patients with higher BMIs, we have invested in additional bariatric equipment designed to improve patient safety and comfort during Cath Lab procedures.

If you have a patient who exceeds the 450-pound maximum, or if special circumstances require discussion, please contact the Cath Lab Charge Nurse at 215-776-4563 or CathLab.Charge@pennmedicine.upenn.edu

# data[].attributes.body
Can access video through Elsevier- search "PCA" or use link provided here!

# data[].attributes.body
You can access multiple restraint resources on the practice and regulatory site under "Patient Safety." Please follow up with nurses as able if their patient is in restraints, since we do not see this frequently.

See pic for how to access!

# data[].attributes.body
Mobile Hoyer lift available on 11 Campus, across from 1144

# data[].attributes.body
Must be placed by RN! Avoid providers placing 1:1 orders.

# data[].attributes.headline
Transducer tubing WITHOUT vamp for code cart: LAWSON 40023788

# data[].attributes.subject
Transducer tubing WITHOUT vamp for code cart: LAWSON 40023788

# data[].attributes.body
The clinical emergency stakeholders have identified MAC Two-Lumen Central Venous Access kit (Lawson 40028004/Ref NA-11242-CDC) to replace Trauma kit (Lawson 100167/Ref AK-05801). This MAC kit is smaller than the large MAC kits you may have seen, as that item is for the ICU's.

The code cart app is in the process of being updated to reflect this change, but sharing for awareness in the meantime.

The code cart is allowed to have both the Trauma kit & MAC kit, as product is depleted.

# data[].attributes.headline
Chest tube drainage system Shortage- how to exchange drainage systems 

# data[].attributes.subject
Chest tube drainage system Shortage- how to exchange drainage systems 

# data[].attributes.body
HUP is currently only stocking a limited supply of "Teleflex Pleur-Evac" chest tube drainage systems (see attached photo).

IMPORTANT- if the patient has an "Atrium Oasis" chest tube drain system (the ones we usually see) and you need to replace the drainage system to Teleflex, they are not compatible at the distal connection site. See instructions below.

To replace a CT drainage system from Atrium Oasis to Teleflex:

1. Clamp chest tube above football site with hemostat

2. Remove tape and zip tie

3. Disconnect football

4. Connect new Teleflex drainage system with new included football

5. Remember to add water to the chamber

6. Zip tie/tape connections

7. Remove hemostat

Best practice would be to complete with 2 nurses!

# data[].attributes.headline
Info for patient's using in-room fridge 

# data[].attributes.subject
Info for patient's using in-room fridge 

# data[].attributes.body
If a patient uses the portable unit fridge in their room, please let the unit secretaries and unit leaderish know. The temperature has to be checked every day by our unit secretaries.

# data[].attributes.body
Current expectations of each discipline during dispo rounds.

# data[].attributes.headline
PD 2L fluid bag shortage for MANUAL PD- New process outlined on tip sheet!

# data[].attributes.subject
PD 2L fluid bag shortage for MANUAL PD- New process outlined on tip sheet!

# data[].attributes.body
There is not yet a Lawson number for the 3L bags, so, in the event of a manual exchange, a call will need to be placed to MM to retrieve the 3L bags. The order for the exchange will also likely remain for 2L (as the ordering of it in PennChart is not yet a clear path), but the bag should scan and nurses should be able to select "titratable drug" to deliver the ordered 2L. Importantly, the nurse should stay with the patient during administration to make sure only the 2L gets instilled.

# data[].attributes.body
For patients receiving chemotherapy on a non-oncology unit , a Chemotherapy Approved Nurse must be present for the administration of all doses of parenteral chemotherapy and/or for the first does of any oral chemotherapy.

A certified chemotherapy nurse can be reached on the Oncology Phone at 215-519-5513.

# data[].attributes.headline
*UPDATED* Anticoagulation Bridging Guidelines for Preop Cardiac Surgery Patients

# data[].attributes.subject
*UPDATED* Anticoagulation Bridging Guidelines for Preop Cardiac Surgery Patients

# data[].attributes.body
For your review and awareness

# data[].attributes.headline
NEW: In room lab label printing- go live 7/22 10am

# data[].attributes.subject
NEW: In room lab label printing- go live 7/22 10am

# data[].attributes.body
See second page of tip sheet for 9 Center frequently asked questions!

# data[].attributes.headline
Neonatal Emergency Equipment & Processes outside of Women's Health

# data[].attributes.subject
Neonatal Emergency Equipment & Processes outside of Women's Health

# data[].attributes.body
Expanded locations of Newborn Airway Boxes:

Newborn airway boxes are now located on ICU Airway Emergency Carts

Respiratory is responsible for checking/maintaining these boxes/process

To provide clarity and ease of distinguishing differences of airway boxes - Newborn boxes are labeled with high contrast lettering

Neonatal stabilization Basinet/equipment

To provide a safe surface and immediate access to neonatal resuscitation/stabilization equipment after an unanticipated delivery "Neonatal Stabilization Basinets" have been created

Located in the Clifton Center/Pavilion ORs & 11 Center (SICU elevators)

Are intended for emergency use prior to individualized neonatal emergency equipment being brought to the patient's clinical area (i.e. - isolette, etc.)

Includes tipsheets and visual cues on core neonatal stabilization steps after delivery (Warm! Dry! Stimulate! Airway/Breathing/Circulation 🙂) and Neonatal Resuscitation Program algorithm for reference

There is a (new!) Clinical Practice Guideline that outlines the workflows for equipment/communication and expectations of WH Department: Workflow for Inpatient Pregnant Patients Outside of Women's Health Department

# data[].attributes.headline
Please review, we had practice issues the last time we had a nitro drip

# data[].attributes.subject
Please review, we had practice issues the last time we had a nitro drip

# data[].attributes.body
The VAD team recently had a request for an updated, basic resource for end of life with LVAD patients, mostly for those situations where patients may be admitted in extremis and the decision is made to discontinue VAD therapy overnight or on the weekend when the coordinators are not physically in the hospital.

From the VAD Coordinator Team:

As always, the coordinators are available 24/7 for help with ANY matters involving this including decision making, guiding patients and families, and actual device discontinuation.

The expectation is that the VAD Emergency Line would be called to discuss the situation prior to any plans or interventions being made to discontinue the device.  Also as a reminder, if a patient is declining and the decision is made to turn off the VAD and a coordinator is not in the hospital, we DO NOT come in to turn off the device as the wait time for us to arrive could detrimentally effect the patient/family and their experience.  All of us are trained to talk nursing or providers through turning off the device over the phone or FaceTime.  If we know death is imminent, we will help prepare as much as we can to ease the process for both patient/family and bedside staff.

# data[].attributes.attachment_link.title
Bedside CVC Placement Huddle Sheet FINAL

# data[].attributes.body
HeartCare® is a non-invasive blood test that uses genomic technologies and donor derived cell free

DNA to identify the absence of cardiac allograft-rejection. HeartCare® combines Allomap® and

Allosure. The Allomap® component reflects immune activation and has been validated to detect ACR

but does not provide information about graft injury. Allosure® measures donor derived cell free DNA

released from the graft in the setting of injury and can detect both AMR and ACR. Thus, when used

together with HeartCare® information is gained on both immune activation and graft injury. HeartCare®

can be effectively used to screen low-risk patients starting at three months post-transplant instead of

routine biopsies. Biopsies are performed if the HeartCare® score is abnormal. Thus, HeartCare® can

reduce the number of invasive biopsies needed in selected patients who meet the indications for

HeartCare® testing, as identified in this protocol

Policy#01-06-05

# data[].attributes.body
Our team is unfamiliar with laryngectomy care, but it is outlined in our HUP Nursing Policy: Tracheostomy and Total Laryngectomy Care (4C-01-10). We will see this population most often under Thoracic Surgery service, but is possible to see a total laryngectomy admitted under any primary service.

Check-ins with nurses caring for these patients to ensure all safety precautions are being followed is warranted. See Leadership with any questions! Policy attached for ease of review.

# data[].attributes.attachment_link.title
Transfer Center for Clinical Staff Tip Sheet

# data[].attributes.body
In the interim of switching vendors this summer, we are to use telephone services (via CyraCom) when unable to secure a video interpreter via Martii. CyraCom is 215-662-2425 (our Pin is 1381) and will add this to the Charge Phone, as well as make a request to add to the Voalte directory for our Voalte phones. Badge Buddies will be ordered and hopefully a helpful way to increase awareness and share the contact information for telephonic interpretation.

# data[].attributes.body
Tipsheet to sign in as charge nurse and covering nurse as well as preceptor and covering nurse on specific patients.

# data[].attributes.attachment_link.title
Signing in as Dual RN Roles Tipsheet_022023 (002)

# data[].attributes.body
RiTUXimab [RESTRICTED] (Penn Medicine Inpatient Formulary) - UpToDate® Lexidrug™

Lexicomp now has a calculator for rituximab calculator! rituximab in lexi<rituximab administration resources<rituximab calculator 2024

# data[].attributes.body
In the event there is NOT a covering IR provider signed in Penn Chart- most often occurring overnight- please utilize the IR Fellow On Call # 215-301-3076.

This is expected to be temporary as there is continued attention to coverage models for the IR service.

# data[].attributes.body
In the event of a needle stick or other body fluid injury (splash, etc), please assist employee impacted through this process and also notify Frances or a member of the leadership team for follow up. This is a distressing time for those impacted.

Process is attached and as follows:

1) Wash Injury Site- wash the area with running water and soap, flush eyes/mucosa with running water/ eyewash (in our soiled holding area on 9 Center)

2) Notify source patient provider- Provider will need to order "OCC EXP" panel and consent source patient for HIV, Hep B, and Hep C testing. This is documented in a provider note.

3) Exposed employee presents to Occ Med (Ravdin 2) during normal business hours M-F 8a-4p or ED on off hours.

4) Complete 'Body Fluid Injury Report' Form- found on the UPHS Intranet page (right hand side, blue panel). This is essential notification to Occ Med provider for follow up to impacted employee.

# data[].attributes.body
Presentation reviews regulatory mandated reporting of safety events

# data[].attributes.attachment_link.title
Risk Management and Pennsylvania Statutory Reporting Requirements - HCRM Week

# data[].attributes.headline
Please do not give orientees VAD pts unless specified under their specific needs

# data[].attributes.subject
Please do not give orientees VAD pts unless specified under their specific needs

# data[].attributes.body
APP removes (usually after 4 hours)

Patients are able to walk with figure 8 once bedrest is complete (usually 4 hrs) if APP cannot remove timely

Just a fancy way to tighten a suture, no contraindications.

# data[].attributes.attachment_link.title
Nursing Guideline for Figure of Eight Suture

# data[].attributes.body
Hopefully won't have to worry about documenting this, but sharing with you all in case!

# data[].attributes.headline
Neurosurgery Overflow Cheat Sheet- Updated 2/2024

# data[].attributes.subject
Neurosurgery Overflow Cheat Sheet- Updated 2/2024

# data[].attributes.attachment_link.title
Neurosurgery cheat sheet for overflow patients

# data[].attributes.body
We see arterial lines infrequently so would be good to review with nurse every time we have one

ABP must be documented every 2 hours (even if aline is in for blood draws only)

Ensure A-line wave form is labeled "art line" so it communicates with NK and can data validate in EMR

Show nurse how to zero art line and review LDA documentation

Review that aline should always be connect and alarms on- if dislodged we need to know! Patient can bleed out within minutes

# data[].attributes.body
This is what bed management should be referencing when deciding what patients are appropriate for overflow. Some patients require approval, when in doubt you can reach out to their charge/APPs for clarification.

# data[].attributes.attachment_link.title
Inpatient -- Myocardial viability with IV insulin protocol 2.3.233

# data[].attributes.body
Must be completed by charge or staff deemed competent

Documented under LDA lab work drawn- "Yes"

Need one-time central line blood draw order- NOT nursing communication

Needless connector "cap" change with each CL blood draw

# data[].attributes.body
Still counts as 1:1! Need proper documentation

**** If you have any issues with PennObserver, please SafetyNet so we can track!

# data[].attributes.body
Post any topics, trends, or issues you may be seeing. Leadership can address and offer resources!

Post by clicking the plus sign, typing content, then hitting publish. Feel free to add a photo or GIF just keep it appropriate :)

# data[].attributes.body
Review Rituximab in Penn formulary and Penn Medicine Inpatient Formulary: Web Links

# data[].attributes.body
1-1 assignment for 1st dose meaning RN has to stay in the room for the 1st hour of administration. Either Charge or resource can cover other patients for RN.

Clarify with provider if first dose of drug needs to be administered at a specific time- team is usually flexible and can be administered when convenient for RN

# data[].attributes.attachment_link.description
Helping healthcare professionals by providing the most trusted drug and clinical information available, delivered across multiple platforms, and easily integrated into daily workflow.

# data[].attributes.body
All PPE and Renuzyme spray stored in Soiled Holding area.

Red biohazard bins are stored in clean green bags in the clean holding area. When needed, you bring the red bin to the room of instrument use and transport instruments covered to the soiled holding area for pre-cleaning ahead of sending instruments to sterile processing.

Charge (or leadership if on-site) is responsible for immediate transportation after pre-cleaning to the PCAM Sterile Processing (SP) area (in SurgiCentre). From Pav 9, you take elevators to 2M and follow signage for "Bridge to Perelman Center".

Don't forget the Sterilization Request Form- you can just fill out the tray name if you do not have the complete list of instruments- and to take a copy for our unit's tracking upon delivery to SP.

# data[].attributes.body
All Charge RNs complete the pre-cleaning competency attached with a unit leadership member and it is stored in your employee file.

# data[].attributes.headline
Sternotomy Cart Checklist- updated 1/2025

# data[].attributes.subject
Sternotomy Cart Checklist- updated 1/2025

# data[].attributes.headline
Emergency Suture Pack Contents- Stored in Sternotomy Cart

# data[].attributes.subject
Emergency Suture Pack Contents- Stored in Sternotomy Cart

# data[].attributes.attachment_link.title
Sternotomy Cart Suture Pack Guide 12.2021

# data[].attributes.headline
Please remember to STAR patients who you intended orientees to care for

# data[].attributes.subject
Please remember to STAR patients who you intended orientees to care for

# data[].attributes.body
Updated 6/24

# data[].attributes.body
One stop shop for all interpretation-related needs!

# data[].attributes.attachment_link.title
HUP Clifton - Patient Dining Contact Escalation 2026.02.24

# data[].attributes.body
We are now live with CNAs dopplering BP

Please check in with the CNAs every shift and ensure they are comfortable with the process

# data[].attributes.headline
Have a patient or family needing help setting up their MyPennMedicine account?

# data[].attributes.subject
Have a patient or family needing help setting up their MyPennMedicine account?

# data[].attributes.body
They can call 1-866-614-7606 for assistance!

# data[].attributes.headline
Kat, Katie G., Nasya, and Sam Y. now VAD competent!

# data[].attributes.subject
Kat, Katie G., Nasya, and Sam Y. now VAD competent!

# data[].attributes.body
There has been recent changes to the initial VAD course to split the day- a beginner session before independently caring for VAD patients and then an intermediate course ~6ish months later.

For assignment purposes, please assign these nurses a STABLE VAD, not fresh implant with hemodynamic issues.

# data[].attributes.body
The CMAC laryngoscope will be stored on 9 Campus, in the respiratory supply closet across from 944. Cardiac Anesthesia and Respiratory leaders have also been notified and will be responsible for notifying their respective teams. It will be reserved for use only in instances of difficult intubations on the floor during a clinical emergency, in which anesthesia requests a CMAC. Respiratory will be responsible for obtaining the CMAC from the closet and bringing to the bedside.

Nursing will not have any responsibility to the laryngoscope, but overall awareness of its presence is important.