7/26/2014 Learning Opportunities #6 - Davis, Aurora

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Learning Opportunities #6
Hi, everyone! Ready for some more learning opportunities? Then let's get it started in here! Woo-hoo!
1) Look under the FYI link in your patient's EPIC chart to see whether a patient needs premeds before
blood products. Only BMT patients with a history of two or more reactions to blood products need to
receive Benadryl and Tylenol as a premed to prevent transfusion reactions. This history should be noted as
a flag in the patient's FYI link. If you know your patient has reacted in the past and it is NOT already noted
under the FYI link, you can create a flag to make others aware. The FYI link can be found as a hyperlink in
the patient's name banner above "Code Status".

Also, transfusion premed orders should NOT be administered for reasons other than transfusion except
with the okay of an NP or MD. So no giving that Tylenol for headaches or fever unless your provider gives
the go ahead.

2) Check a one hour post platelet by printing a sticker using the release button. After replacing
platelets on a BMT patient, protocol dictates that you check a platelet level one hour after the infusion is
complete. As part of that protocol, there's an existing PRN order for a platelet count. Find the order by
going to "Order Review-->Active Non-Meds-->Platelet Count (frequency: PRN)," select it, then click the
"Release" button located at the top of your orders. It will create an order for a platelet count and give you
a hyperlink to print a label on your Patient Summary. No need to enter a new order! (FYI, this method also
works for those Q6H PRN PTTs for heparin drips.)

3) Pain Education sheets are now available in Spanish. I know you all adore those orange Pain Patient
Education tools, and you can now get them in Spanish for your patients. The lovely Cathy has ordered
them, and they're available at the PSC desk per your request.

4) You can order a type and screen sticker at the same time you order blood to be cross
matched. When you order PRBCs and the patient does NOT have an active type and screen, if you click
the box next to that option it will allow you to order your T&S at the same time. Then you can draw the
T&S and send it off to the blood bank. Once they receive it, they will immediately begin processing the
type and then go straight to adding on the cross match. No need to late add it after the type comes back.
5) If you unhook a line from a patient and leave it dangling, even with a sterile cap on the end, the
line is now good for only 24H! This is called an intermittent infusion. You may have heard that if you
unhook a secondary line, its only good for 24H, but you may not know that this also applies to primary
lines. If you unhook your patient then you need to change your stickers to reflect the fact that the tubing
will expire in 24H! You can avoid this by leaving your patient hooked up all the time, which should be your
method of choice anyway to avoid line infections.
Davis, Aurora
Sat 7/26/2014 10:05 AM
To:UCH-AIP 11th Onc RN <UCH-AIP_11th_Onc_RN@uchealth.org>;
7/26/2014 Learning Opportunities #6 - Davis, Aurora
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6) You should not be charting "Unit Collect" or "Lab Collect" when you chart that you drew labs. This
line is for use at UCH North campus. We don't use it here at Central. You just need to chart "Specimen
Collected" (blood, blood culture, etc.) and "Specimen Source" (which lumen of the line).
In an effort to keep everyone's interest, I'm going to try to keep these emails a little shorter. They'll have
fewer items in them, but will be sent out a little more frequently. Let me know what you think of the new
format, or if you preferred the longer emails.
Thanks, everyone. As always, let me know if you want more details about something or have questions.

"Party on, Wayne." "Party on, Garth."
Aurora
Aurora Davis, RN, BA, BSN, OCN
Relief Charge Nurse, Oncology/BMT Unit
Co-Chair, Pain Champions Committee
University of Colorado Hospital
Aurora.Davis@uchealth.org