STRATEGIES FOR PROFESSIONAL PRACTICE: UNIT two

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STRATEGIES FOR PROFESSIONAL PRACTICE UNIT two

• II TIME MANAGEMENT
• C SETTING PRIORITIES

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SETTING PRIORITIES

• To plan effective use of time, nurses must
  understand the big picture.
• No nurse works in isolation
• Nurses should know what is expected of their
• Cooworkes
• What is happening on the other shifts
• What is happening in the agency
• What is happening in the community

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PRIORITY SETTING

• How do you set priorities for each patient?
• What strategies will you use to priority set for
  each patient?
• What parts of your data will help you set
  priorities for each patient?

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EXAMPLES OF IMPACT OF BIG PICTURE ON NURSE

• If the previous shift nurses were stressed by a
  crisis, the next shift may not get started
  smoothly
• If areas outside of the unit are overwhelmed, a
  nurse/tech might be moved to assist on the
  overwhelmed unit
• When nurses take the big picture into
  consideration, they are less likely to be
  frustrated when asked to assist others
• The nurse can then build into their time
  management plan the possibility of giving and
  receiving assistance

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CRITICAL PROBLEMS

• How do you determine you have a critical problem?
• What do you do with your plan of care at this
  point?
• What characteristic is necessary in the caregiver
  to make critical problems bearable?

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FIRST PRIORITY LIFE THREATENING PROBLEMS WITH
ABCS

• Pt whose condition is life-threatening is the
  highest priority and requires monitoring until
  transfer or stabilization
• These can occur at any time during the shift and
  may or may not be anticipated
• ABCS. Remember Maslows Hierarchy of Needs.
• See high-priority unstable patients who have
  threats to their ABCs (airway, breathing, and
  circulation)
• These patients require nursing assessment,
  judgment, evaluation until transfer or
  stabilization
• Monitor equipment and assess observations used to
  support the status of patients ABCs

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SECOND PRIORITY SAFETY

• Ask yourself
• Are there any threats to patient safety and
  security
• such as threats of violence,
• need for fall prevention,
• infection control
• See these patients next

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THIRD PRIORITY Comfort, Teaching and other needs

• Assess the patients other needs and prioritize
  using Maslows hierarchy.
• May include
• love and belonging,
• self-esteem,
• and self-actualization

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WHO IS SEEN LAST?

• Stable pts
• who need standard, unchanging procedures
• and have predictable outcome are seen last

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TOP PRIORITY PATIENT CARE GROUPS respiratory

• Airway compromise
• Severe respiratory distress, indadequate
  breathing
• Critical asthma
• Chest trauma with respiratory distress

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TOP PRIORITY PATIENT CARE GROUPSCardiovascular
and Neurological

• CARDIOVASCULAR
• Cardiac arrest
• Shock or hypotension
• Ex-sanguinating hemorrhage
• NEUROLOGICAL
• Major head injury
• Unconscious or unresponsive
• Active seizure state

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TOP PRIORITY PATIENT CARE GROUPS Musculoskeletal
and Skin

• MUSCULOSKELETAL
• Major trauma
• Traumatic amputation extremity
• Major cold injury hypothermia
• SKIN
• Burn, greater than 25 body surface area (BSA) or
  airway involvement

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TOP PRIORITY PATIENT CARE GROUPS
Gastrointestinal and Gynecological

• GASTROINTESTINAL
• Difficulty swallowing with airway or respiratory
  compromise
• Abdominal trauma
• Penetrating or blunt
• GYNECOLOGICAL
• Vaginal bleeding, patient with abnormal vital
  signs

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TOP PRIORITY PATIENT CARE GROUPS
/Immunologic/Endocrine/Infection/Child or Elder
Abuse

• IMMUNOLOGIC
• Anaphylaxis
• ENDOCRINE
• Hypoglycemia altered consciousness
• INFECTION
• Septic shock
• CHILD OR ELDER ABUSE
• Unstable situation or conflict