Hand Washing

How disgusted are you when you are in a public restroom and someone does not wash their hands? Ew. How would you feel if your nurse didnt wash their hands after dealing with your sick roommate? It happens. You do not want to be the cause of a nosocomial infection (a hospital acquired infection) and the first way to prevent this from occuring is to wash your hands. You should be doing it for at least 30 seconds and there should be a lot of suds!! Like so:



This is just a googled image of "hand washing suds". Sounds dumb, but come on. Your hands dont even feel clean unless you get the suds going. And the quick water rinse with no soap is just gross. Dont even try if you're just going to rinse.



Obviously I took this picture, seeing as it's flipped. Hand sanitizer. Not a replacement for hand washing BUT is good for inbetween patients and after touching things the contagious patient came in contact with (i.e. food tray or personal belongings).

The 6 Rights

There are six rights of medication administration They are:

The RIGHT:
1. Patient
2. Drug
3. Dose
4. Route
5. Time
6. Documentation

The six of these are very important. One of the most common med errors is due to a nurse giving a med to the wrong patient. What a dumb mistake. The first thing you always do when dealing with any patient is check their ID bracelet and compare it to documentation (MAR). The right drug is important because many names of common drugs are very similar. There are lookalike/soundalike medications that can cause a med error and huge complications with your patient. Dosage is important. If something written on the MAR doesnt look right, stick with your gut. It could have been transcribed wrong. The route makes a huge difference. Something that is given IM instead of SubQ changes how quickly the med is absorbed and could have dire consequences. Time: make sure all meds are due within 30 minutes of the time you're giving them. With pain meds, make sure the last dose was not given 10 minutes ago. Lastly, document everything you do immediately after. If you are working with another nurse, they could accidently double up a med if you did not document that it was already given.

This is a list of lookalike/soundalike medications from the joint commissions.

http://www.jointcommission.org/LASA/

This is just a picture of some OTC medications. Depending on your facility, they may or may not need an MD order. Although they are OTC, they can be just as dangerous as precription drugs if administered wrong.  

The Breathalyzer

Some of you may be familiar with this for reasons irrelevant to nursing. This is used at my work to, of course, test alcohol levels in the blood using a patient's breath. First, you need to turn the device on. Hold the power button until the numbers appear. Then have the patient blow out into the plastic piece until the device beeps. It will then give you a percentage you need to document. The plastic piece is disposable, so dont reuse!
Here is a link that shows a demonstration on using a breathalyzer.

http://www.youtube.com/watch?v=zOwI5GtN4fk

This is a picture of the breathalyzer we use at my work. Different from the above video, but very similar.

Why So Sterile?

One of the first skills you will learn as a nursing student will be donning sterile gloves. It's something that is easily disregarded by new nursing students, seeing as you have a million other things on your plate. BUT, it is extremely important to learn how to don sterile gloves properly in the beginning. Before you know it, you will be doing procedures such as catheter insertion and trache care. There is nothing more embarrassing than starting getting tangled up in gloves that are stuck to your sweaty palms. It should be, by far, the easiest part of any sterile procedure. Remember, sterile procedures are sterile for a reason. If you break that sterility at any point, you put the patient at risk for infection.

Here is a video that will help you:

http://www.youtube.com/watch?v=pAKZ3mdFIj4

When I was in nursing school, I was big on Post-it notes. This is a picture of one of the sticky notes in my skills binder that helped me remember what NOT to do when applying sterile gloves.

ACCU Checks

ACCU check refers to the use of a glucometer to test a patient's blood sugar levels. It is definitely one of the easier skills in nursing and you will become rather familiar with it since many people who are hospitalized are diabetic. The normal range for blood glucose is around 70 to 100.

How to perform a glucose test:

1. Check the doctor's orders.
2. Gather equipment.
3. Wash hands.
4. Identify patient.
5. Choose any finger besides the thumb and index.
6. Stick with a disposable lancet on the side of the finger.
7. Apply droplet of blood to test strip.
8. Wait for an acurate reading.
9. Dispose of all supplies.
10. Wash hands.
11. Document.

Remember that if you get an abnormal reading it will most likely follow with a nursing intervention. If it is high, the administration of insulin via a sliding scale will be ordered and if it is too low, you will either give a glucose tab or orange juice.

Here is a link to a YouTube video that demonstrates this procedure. Good luck!

http://www.youtube.com/watch?v=UQZRjmjcMZs


This is a picture I took of glucose tablets that you would administer to a patient with a low blood sugar level.