Week 1 - Hospital Orientation

A whole day of lectures was devoted to introducing us to the hospital's philosophy of care and policies.

Patient outcomes:
• Health goals are met
• Positive experience
• Not harmed
• Timely communication

Regular assessment of patients’ basic needs (hourly checks):
• Pain
• Toileting
• Mobility
• Environment
• Other – ie, “is there anything I can do for you?”

Criteria for a MET (Medical Emergency Team) call:
• Resp rate > 36 resps per minute or < 6
• Oxygen saturation of <90% on oxygen
• Threatened airway
• Systolic blood pressure < 90
• Heart rate > 140 or < 40 beats per minute
• Sudden drop in Glasgow Coma Scale by 2 points (neurological score)
• Prolonged seizures (could be a stroke)
• Uncontrolled pain
• Other serious concern (eg. uncontrolled bleeding)

Nurses’ role during a medical emergency:
• CPR – compressions and/or bagging (breaths)
• Medication
• Reassurance
• Runner
• Scribe
• Remove clutter
• Reassure other patients and visitors who are nearby
• Information
• Delegate roles
• Interventions

Policies:
• Hand hygiene
• Manual Handling
• Risk assessment and management
• Patient aggression
• Infection control - For gastroenteritis, staff must not come to work for 48 hours after their last symptom of vomiting or diarrhoea, because they will still be infectious. Gastro can KILL elderly people, infants, and those with compromised immune systems.

Adverse Events
In Australia the statistics are that 16% of patients admitted to hospital experience one of the following during their stay:
• Medication error
• Fall
• Pressure ulcer
• Wrong blood
• Hospital acquired infection
• Wrong site surgery or wrong procedure.