Monday, 7 December 2015

How Should a Nurse Mitigate the Interruptions to Reduce the Medication Errors?

When it comes to the blunders committed during the medication process of a patient, there are a lot of people we blame upon. Not a new thing to show up. However, we rather stop considering nurses analogous to machines. When even machines fail to flag inaccuracies, sometimes even a nurse fails to do so. It does not make the profession in any case lesser noble or compassionate.

Be it any ailment, the settings wherein health care professionals are meant to work, consist of many physical systems. There will be colleagues, team members, equipment, science, and the technology itself. It's notably amazing how far the healthcare settings have reached in terms of advancement and technological revolution. At the same time, it's never possible that a patient gets afflicted because of a single person. So, who shall be blamed? Well, interruptions have been identified to be one of the informal factors in medication administration errors.

To prove this right, it’s done practically. By that we mean- a reputed hospital in Toronto, actually practiced mitigating the effects of interruptions by applying some sustainable safety interventions to the medication administration.

The first scenario of the practical procedure of proving that interruptions are the major reason for afflicting the state of any patient, included certain medical procedures to be done while getting interrupted by various sources. The rate of the errors which occurred was documented.

Continuing the practical procedure, the second scenario involved interventions. You must be wondering which kind of interventions would have been involved. For the suspense to end, a user-centered approach was incorporated, which means, a focus group was asked to gather the feedback.

Moreover, to remind the nurses to check the connections, clamps and programming; signage was adjoined to infusion pumps. Further, 'do not interrupt' signs were posted on equipment and in the key areas. Critical medication checks were made to be done in verification booths that isolated nurses from outside disturbance and noise. A countdown timer was given to the nurses who were meant to perform timed operations such as to deliver IV push medications. Not only this, a standardized procedure was started in order to verify the drugs before the administration. This ensured accuracy.

Lastly,
When both of the scenarios were compared, it was found that the human factors did really affect the medication process, not in a very good manner. The second scenario was proved to be more preferable. These interventions were really proven to improve the overall medication process and reduce errors in push volumes, volumes of ambulatory pumps, pump programming and IV drug push rates.

However, notably a nursing student shall confront such cases in order to cope up with the real life situations and the potential troubles; the reason why Simulation Based Learning and countless specialized nursing courses are offered these days.

Tuesday, 1 December 2015

A Perfect Guide for Nurses to Prepare ACLS Certification Exam

No nurse takes ACLS certification exam lightly. After all, the preparation for how to respond to the moments, which bring difference between life and death at the true time of emergency, is not something to be taken casually. Undoubtedly, Advanced Cardiac Life Support is an essential facet of an emergency medical treatment and so do is its certification exam. The certification exam is there to make sure that the nurse is finally acquainted with the professional skills to handle emergencies regarding Advanced Cardiac Life Support.

Down here, we’ve listed tips for you to follow while studying for your ACLS certification exam:


Get an Idea about Already Occurred Situations

For you to know various situations in which your ACLS skills are going to be utilized you have to review various case studies. The scenarios you encountered in your entire ACLS course have full chances to appear in your certification exam. However, studying only those cases is not a wise step. Instead, try to have an overview of all kinds of scenarios for you to be comfortable while addressing various situations in your forthcoming career as well.


Study, Review, and Memorize the Algorithms

ACLS is connected to a number of algorithms, which shall be memorized by you. Yes, do not just read them out and review them, it is compulsory to memorize them and remember them at the time of emergency as well. Whatever your learning style may be, just choose the best way that makes you learn the procedures of the following algorithms:
  • V-Tach
  • V-Fib
  • Tachycardia
  • PEA
  • Bradycardia
  • Asystole


Knowing Which Medication Is Needed and When It Is Needed

Identification of medications as per the occurring situation is vital to any critical emergency situation. Not only the medication, but also the correct dose level shall be known.


Remember Your H's and T's

In order to apprehend completely the ACLS algorithms, you have to stick to the mnemonic device theme. Learning your H’s and T’s make you able to cure a patient who might have possible causes of these H’s and T’s. Here they are:

The H’s
  • Hydrogen Ion (Acidosis)
  • Hyper or Hypokalemia (Potassium)
  • Hypovolemia
  • Hypoxia
  • Hypothermia
The T’s
  • Thrombosis
  • Toxins
  • Tension Pneumothorax
  • Tamponade


Understand the Heart Rates and Rhythms - ECGs

You should have an experience with ECGs and the prospective way to react in such situations. You can improve your ways of understanding in case you are not yet comfortable with them. Watching YouTube videos helps. Though, taking an ECG specialized course would be highly recommended.


Down here, we are going to give you some test-taking tips:


Read EACH & EVERY Question Carefully

Pay attention! ACLS Certification exam has certain technical and dense information that requires reading between the lines. In case you don’t slow down and read each question carefully and attentively, you might end up answering it incorrectly. You have to apprehend the exact and the actual meaning of the question and then attempt to answer it. You cannot let these ‘minor’ mistakes ruin your score.


If You Know the Answer, Then Write It First.

Make sure you answer the easier questions first. Don’t get stuck onto a particular question, which you do not know. Else, you will end up wasting time and left with the answers you know. Therefore, it’s wiser to answer the questions you already know perfectly. Moreover, being caught on that one question you have no idea about will end up giving anxiety and frustration. Do not let your memory get stuck regarding the answers you know too. Not knowing the answer? Move on. Come back only once you’re done with those you are aware.


Last Significant Piece of Advice - Relax!

Well, is there any need to mention this? The answer is yes. Many nurses end up being nervous while test taking. No, you will mess up everything this way. Learning and memorizing all the algorithms will help you a lot and it’s rather quite overwhelming to be familiar with most of the stuff related to Advanced Cardiac Life Support. However, in case you will not stay calm, you might get confused and all jumbled between all those algorithms. It’s important to stay calm and trust on what you’ve prepared for the exam.

Don’t forget that fortune favors the prepared. All the best!

Wednesday, 28 October 2015

CODE BLUE – Being a Nurse, You Need to Know It

CODE BLUE
As Wikipedia says - "Code Blue is generally used to indicate
a patient requiring resuscitation or in need of immediate
medical attention, most often as the result of
a respiratory arrest or cardiac arrest"
No matter, if you are an experienced nursing professional or a newbie, these two words are feared by both and if it is your first time, definitely it will be an experience of ultimate panicking. Surprisingly, it will make you feel as if you are unable to recall everything you have ever learned in your nursing education. Well, that’s Normal!

Sometimes, you may think that you are a terrible nurse when such things happen, don’t worry, it has been experienced by every nurse at some point in their nursing career and if anyone says it never happened, believe us – it’s a lie.



Here’s a story of a RN Daphne Neuhaus in her own words as published in the blog of NCLEXmastery.com

"I will never forget my first code blue.
I went back to check on my patient when I heard her continuous pulse ox start beeping like crazy. It said 60% and she had become unresponsive. A Code Blue was called, but before the code team arrived, we needed to put a board under the patient, remove the head of the bed and immediately start compressions and start bagging her.

I was white as a sheet and thankfully had another nurse on with me that kept things calm. I remember the first set of compressions I did and felt the patient’s ribs crack. The team arrived, which is about 10 people.I alternated with a male nursing assistant doing chest compressions…it is like an insane workout. I have watched multiple nurses have to straddle the patient literally to get enough force. We intubated the patient, but we never could get a heart rhythm or get her oxygen levels to come up.About this time, we reached her family and they said to make her a DNR. She unfortunately had thrown a massive pulmonary embolism and she died.

Each time got a bit easier and eventually I became the "calmer" of the other newer nurses, but I was still as terrified as anyone was. You, as well, will become that person as your career progresses."

To help first timers cope up with Code Blue situation, here is some advice from Daphne Neuhaus –
  • Give about 10 seconds to prepare yourself. If you panic, you are of no help. Call a Code Blue as per the protocol set by your healthcare facility and if family members are close, ask them to leave the room.
  • Put the patient on a flat position and if there is no pulse, start compressions and put on the ambu bag to start breaths with the help of a nursing assistant or a fellow nurse. Check the rhythm of the heart and access to IV. With a bit of luck, the Code Team would arrive by this time and will take over; however, you still need to be in the middle of it.
  • More the number of times you face such situations, it will get easier for you to handle the primary stage. No matter how many times you did it, you will always feel terrified in first few moments. 

Code Blue is a situation where your skills and practical experience helps to save a life. To get hands-on experience of such situations, INSCOL provides simulation-based training workshops for nurses in Airway Management, ECG, Cardiovascular Assessment and more. To know more about the workshops, visit http://www.inscol.com/india/cce

Friday, 9 October 2015

Nursing Education: Human Factors and Patient Safety

Human Factors and Patient Safety - INSCOL BlogsMost of the nurses may surely have heard the term ‘human factors’ in their study period or while practice. However, another fact is that they do not really understand which kind of detrimental effects it can put in their practical work as well as to their patients.

As a whole, healthcare professionals operate within settings that include many physical systems such as- colleagues or team members, equipment, science and the technology itself. It’s amazing how healthcare settings are under the constant revolution of changes and advancement. However, along with this revolution there is always a precaution to be taken. For instance, the presence of such many physical settings leads to many adverse consequences of setups that affect the patient as well. 

As far as the interaction of humans with all these settings is concerned and how this interaction affects the safety of the patients is concerned, this study is segregated as a unique discipline known as the ‘study of human factors’. Nurses shall be acquainted with the details of human factors that may affect the procedure of their healthcare towards the patient. 

It’s been very rare that a patient might get affected by the settings around him/her just because of one person. Nevertheless, in case a patient has undergone an inadvertent, an unintentional harm, the blame is eventually put on a single person. However, the study of human factors in nursing implies that humans shall not be held responsible for the errors occurring due to usage of technology. After all, if the user of a machine commits a mistake, this is primarily because of some faulty design law of the machine itself. 

For example, a nurse is taking care of a cancer patient who requires radiation therapy. The patient’s treatment procedure is fed to the machine delivering the radiation. However, when the error message is displayed on the screen of the machine that ends up being not at all informative. In such case, the physicist who fed the procedure in the machine would think that everything is perfectly fine with the treatment. However, in fact, the machine is fed only with half of the procedure. Now, the cancer patient can be severely burnt. Is it the fault of the physicist? 

Well, from the point of view of human factors, human is a creature that is fallible. No matter how highly qualified or trained you are, mistake happens and to err is human. Maybe, we work in settings that make us prone to commit mistakes, which are unintentional in the first place, but the matter that bothers us is that nurses shall be equipped with the skills of minimum possible errors occurring due to the colleagues, team members, tools, interfaces, devices and technology. After all, all of these are part of their job. 

These days, there are courses such as 'Human Factors in Nurses', which aim to make nurses practice in a simulation based workshop which introduces the varying interactions between all the physical settings to them. It’s an initiative to trigger the psychological quotient of the nurses and make them intuitive and easy at technology, machines and procedures. To know more in details about the courses, please visit http://www.inscol.com/india/cce

Tuesday, 4 August 2015

How Simulation Based Training in ECG Benefits Nurses?

Simulation Based Training in ECG ECG is a depiction of heart’s electrical activity and is regarded as one of the oldest and simplest forms of cardiac investigation. This device is used by physicians, cardiac specialists, nurses and other healthcare staff to assess the disease of the patients especially in case of cardiac patients. It gives health providers an understanding of mechanisms, progressive treatments and effective ways to treat deadly arrhythmias.

In a medical facility where patients with problems related to heart are treated, ECG, commonly known as Electrocardiogram, serves as a vital equipment in assessing the heart’s condition. An ECG or EKG is a diagnostic test that checks for problems related to the electrical activity of your heart. At the same time, an EKG translates the heart's electrical activity into line traced on a paper with spikes and dips throughout the waves for the doctor’s or specialists to assess the condition of the patient. 

Healthcare professionals who want to develop skills and confidence in analyzing ECGs can join training courses and workshops especially designed for them. INSCOL Center of Continuing Education (CCE) is one such leading organization that provides one day simulation based workshop on ECG accredited by University of West London. The main objective of this workshop is to provide participants with the knowledge, skills and confidence required to analyze ECGs.

This workshop focuses on mainly ECG monitoring, traces and interpretation. It also helps participants to interpret the arrhythmias and conduction disturbances. Additionally, they become skilled to critically analyze normal and abnormal wave patterns, interval segments and QRS axis from rhythm strips.

Further, INSCOL CCE offers a wide range of courses and simulation based training tailored for Indian Nurses such as Birth emergencies & maternal advanced life support, airway management, advanced neurological assessment, advanced cardiovascular assessment, ECG made easy and more. Besides, hands on exposure on industry best simulation equipment participants have a unique advantage of earning International Certification from foreign universities while they study or work in India.

For more info on simulation based training & learning http://www.inscol.com/india/cce

Friday, 17 July 2015

How Essential Is Using Reflective Practice In Nursing Care

Reflective Practice is a guide for nurses to develop and learn from their own practice. It is considered a valuable tool especially in nursing profession wherein professionals are encouraged to learn from their own professional experiences and develop the capacity to reflect in and on practice resulting in the advancement of expertise.

What exactly is reflective Practice?


Reflective Practice is a dynamic process wherein an individual consciously make an attempt to analyze and learn from their day to day professional experiences giving them an insight into self and their practice. These new insights enable them to respond to similar clinical situations with an improved perspective. This process of reflective practice develops critical thinking, improves approach to patient care, promotes self-awareness and develops communication skills.

Reflective practice is not about complaining and whining rather this a process of working towards a goal to thoughtfully study the situation and identify problems that needs to be addressed, take note of skills that need to be strengthened and work on perspectives that need to be changed. It is recommended that most effective way for reflective practice is having a written narrative that will enable you to analyze the situation clearly and in an in-depth way. Professional nurses who want to learn the concept of reflective practice can join workshops or training courses offered by leading health care organizations and can relate significance of reflective practice in the contemporary healthcare setting.


INSCOL through its Centre of Continuing Education CCE offers a one day simulation-based workshop on Reflective Practice catering to professional nurses and other healthcare professionals. The main aim of this workshop is to provide learning that results from past experiences and results in the development of new perspectives & professional growth. After successfully completing this workshop participants will be able to apply the concept of reflective practice confidently and will be able to plan their own learning by applying various strategies of reflection.

Further, it offers a wide range of courses and simulation-based training tailored for Indian Nurses such as Birth emergencies & maternal advanced life support, airway management, advanced neurological assessment, advanced cardiovascular assessment and more.

For more info on simulation based training & learning http://www.inscol.com/india/cce

Thursday, 4 June 2015

4 Smart Tips to Control Your Temper as a Nurse

Being a nurse you often go through tough times, be it about dealing with complex patients or dealing with other stressful situations at work. However, if you often find yourself fuming over trivial things then it is important to deal with your anger in a positive way as uncontrollable anger can take a toll over your professional and personal life. To start with, consider these smart tips that will help you keep you cool when faced with frustrated situations at work.

1. Seek Professional Advice

Before thinking of controlling your temper, first step is to examine yourself. Introspect and find out if anger management has become an ongoing struggle for you and have created disturbance and damage in your life in the past. If the answer is yes, then accept it without any hesitation that there is a problem to work upon. Once you admit it to yourself, you will be able to seek professional advice in a better way. You can go for individual counseling sessions, such sessions are of great help and allow you to get a grip on your anger issues and control your temper.

2. Temporarily Avoid The Situation

If a specific situation is making your temper out of control then in such situation best you can do is temporarily remove yourself from the situation. It is good to physically remove yourself from the situation that is creating stress and causing you to lose your temper. Even if it looks rude that you are walking away from the situation, excuse yourself politely if you will stick around you will make the things worse. So better avoid such situation.

3. Respond Don’t React

In any situation that causes you stress,it is good to calm down first and then think through it. When your mind is calm, you can weight things better and understand others point of view as well. Make it a point whether you agree upon something or disagree, always make it a point to respond never react.

4. Using Relaxation Techniques

To control your temper, other thing you can adopt is using relaxation techniques every day. There are many relaxation techniques you can practice in your everyday life like breathing exercises, meditation, and prayer. Make it part of your daily routine instead of practicing it only on tough days.


These tips will come handy to deal with immediate conflicts properly and will also help in controlling your temper.