Lovenox Workflow: Creating a Flowchart Workflow is a series of sequencial steps that take place, creating a process to complete a task. The process, generally speaking, involves two or more individuals and creates or adds value to an organization. Workflows are a standardization of work that takes into account quality, productivity, cost, safety and moral depending on the type of process flow (Liker & Meier, 2006). Workflow analysis includes observation and documentation of the process to better understand the current state. Viewing the current state, one can then begin to analyse the process, looking for opportunites of redesign, waste, and value added activities (McGonigle & Mastrian, 2012). “The focus in any process is always on creating …show more content…
If the hours are between 0800 and 1600, the provider or radiology technician calls the anti-coagulation clinic. The Lovenox protocol is then follow through via the anti-coagulation clinic. Should the diagnosis come after 1600 and before 0800, the provider much call the nursing supervisor. The provider will give an order to intiate the Lovenox protocol. It is the nursing supervisors responsibility to write the orders and enter the lab orders into the computer. A phone call to the Lead ED RN is then made by the nursing supervisor to alert that a patient will be coming to the ED for basic teaching and an injection. The nursing supervisor greets the patient in the radiology department, inquires as to which pharmacy the patient utilizes, and escorts the patient to the ED, with a patient hand-off given to the Lead ED RN. The patient has the ordered lab work drawn and waits for the results. Once the labwork is return, the first Lovenox injection is given by the Lead ED RN. The ED RN then calls the anti-coagulation clinic, leaves a voicemail with the patient information and faxes the orders received from the provider. The patient is instructed by the Lead ED RN that the clinic will call in the morning to arrange follow up lab work and appointments for injections. The anti-coagulation clinic takes over from this …show more content…
There is the use of telephone calls to communicate with the Lead ED RN and calling the anti-coagulation clinic by the Lead ED RN to refer the patient to the clinic. The computer order entry system is used by the nursing supervisor to enter in the lab work which is needed to dose the Lovenox. The orders received from the provider for the Lovenox and the anti-coagulation referral are faxed to the clinic by Lead ED RN.
Policies and Rules A Lovenox policy and protocol is in place in the organization. This policy must be followed when a patient needs to be on Lovenox injections; therefore, the policy is in place from the beginning of the Lovenox flowchart. The Lovenox policy dictates the how, when, and why of this flowchart. The who and where is left open for discussion and analysis. The anti-coagulation clinic within the organization is open from 0800 until 1600, Monday through Friday.
Any patient being diagnosed on an outpatient basis will follow the current workflow presented.
Metrics used for Workflow
As a standard precaution against bodily fluids or blood borne pathogens the medical assistant and the doctor would don their personal protective equipment (PPE) such as gloves, face shield, and gown. Next, the medical assistant will prepare the following materials in preparation of the procedure: 1% or 2% lidocaine in a 10cc syringe/25 gauge needle, skin prep solution, #11 scalpel blade with handle, gauze, hemostat, scissors, iodoform, tape, and culture swab. After the materials have been prepped the doctor will clean the abscess with skin prep and drape the wound with sterile fenestrated drape. Anesthetic in the form of lidocaine with a 10cc syringe and 25-gauge needle will be injected around the abscess. The doctor will allow 3-5 minutes for the anesthetic to take affect before making an incision into the abscess. Once the incision is made the doctor will allow pus to ooze and drain out. While the pus is draining out, the culture swab will be inserted in to the abscess where a culture is taken so the origin of the infection is identified incase further treatment is needed. Using the hemostat the doctor will explore the abscess and continue to soak up the pus with the gauze. With a syringe and normal saline the doctor will irrigate
Additionally, the LPN cannot push medications into a peripheral intravenous line if the patient “weighs less than 80 lbs, is prenatal, pediatric, or antepartum”, although given that the situation is on a general med-surg floor it is unlikely these patients would be under Sarah’s care at this time. (Rules and Regulations of Practical Nurses. 2015) Sarah can delegate the postoperative patients who need dressing changes and ambulating them to the LPN, but Sarah should assess the wounds for complications initially and serve as resource to the LPN if she has questions about the wounds. Additionally, she could help the nursing assistant with answering calls and serve as a reference for the nursing assistant to ask questions or help with tasks if Sarah is not available. With regards to supervision, the LPN would need continuous supervision given that the working relationship is new. (Cherry and Jacob, 2014) Sarah should be available and willing to answer any questions or address any concerns the LPN
The CNO’s scope of practice statement is, “The practice of nursing is the promotion of health and the assessment of, the provision of, care for, and the treatment of, health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function” (College of Nurses of Ontario, 2015). The goal I set for myself is, to learn and understand the scope of practice of an RPN in order to be accountable for all my actions as a future nurse. The reason I feel I need further development in IV therapy is because, in my current clinical setting at the hospital, the majority of the patients I have cared for are on IV therapy. As a nursing student, we have just started learning about IV therapy. I will also use the CNO standards for medication when administering an IV solution because it is a medication and the 10 rights need to be applied (CNO, 2015).
will require intravenous cannulation” (Ogston-Tuck, 2014). The key to prevention is knowing the cause of the problem. Some key nursing interventions as noted in the [Manual of IV Therapeutics] include using aseptic technique
...kly administer medication to a patient that is in urgent need of it. How this medication ends up in the blood stream to effect a change in a patient’s body is determined by the adherence to the standard steps of inserting an IV. This includes finding a peripheral or central vein; inserting a hypodermic needle; and regulating the amount of fluid that goes into the blood stream from the bag containing the liquid medication or nutrients. The IV infusion must be monitored intermittently to ensure that the needle does not become dislodged from the vein and pours its contents into surrounding tissue. This could lead to irritation, pain and other symptoms. Also the rate of infusion must be appropriate for the medication being given because too much infusion can cause other problems for the patient.
The patient was identified and the procedure was explained preliminary to administering the injection, to ensure the patient fully understood the procedure and to gain consent from them. The possible side effects of the medication were outlined aswell. ...
Bjerke, Juel M. "Week 2 Lecture Notes - Achieving Business Process Excellence and Process Re-engineering." MFGO 601 - The Globally Integrated Manufacturing Company. 2 Nov. 2011.
According to doctor’s order, repeat CBC at 1600hr and if the HB is less than 80 transfuse two units of PRBC and lasix 40 mg in between the transfusion. I visited each patients room and around 4PM I entered Mr.Govanni’s room and I noticed that he was doing something with his mobile and I greeted him but he replied without looking at me by shaking his head and said, oh!.. yes, and he continued what he was doing....
It is a step of defining the goals of the projects and the results are aimed at reaching certain levels of productivity of customer satisfaction. The second stage is measure, and it is the stage of collecting data and facts and evaluating current operational performance. The third stage is analyze with the purpose of developing methods and theories that will best suit the solving of the problem; it is also a stage of detecting cause-and-effect ties of the processes. The fourth stage is improve, it is aimed at generating ideas for reaching the desired process improvement. Finally, there is the control stage that is about monitoring the operations to find out whether the process of improvement is smooth and the problems were solved (Meredith & Shafer,
administered to prevent clots and perhaps continues post-op. If such a patient is not given
...f the clamps on the tubing to allow the IV solution to run freely. Slowly, decrease the flow of the solution to the appropriate rate as ordered by the physician. Using a small gauze pad, wipe away any excess blood or fluid on the surface of the skin. Then, using the pre-torn pieces of tape, secure the catheter hub and the IV tubing to the patient’s skin. Take extra caution not to kink the tubing. Once everything is secured, recheck the IV solution’s flow and then attend to the rest of your patients needs.
The registered nurse supervises the delegation by monitoring performance with the standards of practice, policies and procedures. Monitoring varies with the needs of the patient and the experience of the team members. The nurse contemplates the health status of the patients, the geographic design of the unit, the availability of resources, the complexity of the task and feedback from the licensed practical nurse and the nursing assistant. Agreed scheduled checkpoints throughout the shift essentially ensure timely intervention and follow up on concerns. Evaluating the patient’s condition and how the team is handling their tasks results in positive patient outcomes (Yoder-Wise,
The patient was transferred into my care via the Emergency Assessment Unit for Surgical Patients (EAUS). I was given handover by the charge nurse who has already pre-a...
Circulating nurses must check the expiry date and the integrity of the packaging and wear the correct PPE prior to opening the articles. Each article must maintain its sterility; therefore the setup must be continuously monitored. Instrument nurses must create the sterile field using sterile drapes as they minimise the transference of microorganisms. They must also keep their hands at chest level, as areas below table height can be easily contaminated (Australian College of Operating Room Nurses, 2010).
Within the analysis phase a set of goals are needed within the domain. From this there are three perspectives which are taken; the object model the Ronald LeRoi Burback (1998) states “dynamic model, and a functional model. The object model represents the artifacts of the system. The dynamic model represents the interaction between these artifacts represented as events, states, and transitions. The functional model represents the methods of the system from the perspective of data flow.” After the analysis phase the system design phase takes place. Here the system is sub-categorized and appointed tasks and persistent data storage is established, also within this phase the architecture is formed. Lastly the object design phase starts and is where the implementation plan is established and algorithms and object classes are also