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Q Tips

Greetings from the Peer Review Committee:

Here are the some “Q”uality tips from our recent meetings:

  • When you have a STEMI patient, use AMAC to activate the MI team.  The call should be initiated by either an attending or senior resident only.  If you choose to call the cath lab directly, be sure to document the time of notification in the chart.  This will help us ensure that STEMI cases are being identified & treated appropriately .
  • In reviewing sepsis cases, we found several patients that meet EGDT criteria but do not get all the indicated interventions in the pathway; most commonly, patients are appropriately getting central lines but CVP or ScVo2 are not being documented.
  • In patients with hemodynamically significant PE (documented or suspected), consider initial therapy with unfractionated heparin instead low molecular weight heparin – we have unfractionated heparin the department so there is no delay in medication administration; whereas lovenox needs to be sent from pharmacy thus adding significant delay in administration.
  • Be sure to wait for results of any tests that you order; seems obvious but there were several cases where an official urinalysis was ordered & the patient was discharged prior to results being obtained – in both of these cases they were positive & the patient was never treated.
  • If the CT scan that you are ordering is EMERGENT, call CT scan or the radiologist to facilitate the study.  Of course, all of our CTs are emergent but there are some that need to be done much more urgently than others so use your discretion.
  • When ordering lovenox, remember to document the patient’s weight in the notes section.  Pharmacy will not dispense lovenox until they confirm patient weight so this will decrease the turnaround time for getting the medication.
  • And lastly … always, remember to document any progress of the case in the doctors notes section of the chart.  This includes anything from “patient was seen by pmd” to “patient feels better after hydration, will d/c home”, etc.  If it’s not documented on the chart, then it didn’t happen.

Thanks for your attention!
Vaishali

Written by phil

December 11th, 2008 at 7:05 pm

Posted in Pearls

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