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NURSES’ INFORMATION
JEWEL HOUSE
THINGS TO KEEP IN MIND
• TB solution EXPIRES 30 days after it has been
opened. Keep track of this. You can put it in
the calendar so that it isn’t missed.
CONTINUED
• As a general rule of thumb…..any meds (other
than pills) expire at 30 days of opening. This
includes flu vaccines.
• Make sure you are dating everything when
you open it. Not just on the package but the
actual container.
Diabetic Supplies
• Any time supplies are
ordered, they have to
send safety sharps and
safety needles.
• You have to document
all blood sugar results.
• We cannot have “house
stock” diabetic supplies.
• If the pharmacy does
not send safety
supplies, call them.
Documentation
• Initialing the MAR is mandatory. No holes can
be in the MAR. Blood sugars need initialed,
filled out, etc. If state finds a hole in the MAR
for insulin or a blood sugar, they can issue an
Immediate Jeopardy tag.
• Daily MAR audits will occur. If there are holes,
disciplinary action will occur.
Documentation Con’t
• Any verbal order in the charts must have an
MD or NP signature. If no signature, then no
chart. Place in mailbox in med room that is
designated for these.
• On the MARs, the residents’ code statuses
need to be on there. I hand wrote them in for
July and I hope that Omnicare will put them
on the August batch.
Nurse Powerpoint
More Documentation
• There are now forms called “72 Hour Observation”.
• This form is used for a Change of Condition. (ie: s/p fall, 911
being called with refusal to be transported, generalized
complaints with an assessment and no new orders.
• The regular Nurses’ Notes are for anything requiring longer
than 72 hour documentation.
Narcotic Count
• All narcotics will be counted with the on-
coming and off-going shifts every day. CNAs
are witnessing in counting of the narcotics.
• DO NOT forget to sign the count sheets.
Coumadins
• Make sure you are keeping track of any
Coumadin changes on the form that is
provided.
• This is critical to complete…….
Nurse Powerpoint
Beginning in July
• MARs and TARs will be in the same binder.
• Our nursing staff will be responsible for
completing the monthly weights and vital
signs as we are no longer allowed to have
hospice come in and do these. Our plan is to
make an activity out of this.
• All residents’ have to have a master signature
log with their MARS. These will stay with them
until they are discharged or deceased.
Nursing No-Nos
• We are not allowed to
draw blood.
• We are in the process of
getting Med-Lab to come
in and do our blood
draws.
• KDH will no longer be
doing our blood draws.
• We will let you know
when this transition
occurs.
• When a resident goes out
for a visit and meds need
to be sent, you have to
send the entire cards,
bottles, etc. No more
individual doses in
envelopes.
• There is a form for this.
Nurse Powerpoint
Nurses/ QMAs
Please sign and date below stating that you have
read and understood the content of this
information. Detach this page and return to ALD.
Name:___________Signature:______________
Title:__________
Date:__________

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Nurse Powerpoint

  • 2. THINGS TO KEEP IN MIND • TB solution EXPIRES 30 days after it has been opened. Keep track of this. You can put it in the calendar so that it isn’t missed.
  • 3. CONTINUED • As a general rule of thumb…..any meds (other than pills) expire at 30 days of opening. This includes flu vaccines. • Make sure you are dating everything when you open it. Not just on the package but the actual container.
  • 4. Diabetic Supplies • Any time supplies are ordered, they have to send safety sharps and safety needles. • You have to document all blood sugar results. • We cannot have “house stock” diabetic supplies. • If the pharmacy does not send safety supplies, call them.
  • 5. Documentation • Initialing the MAR is mandatory. No holes can be in the MAR. Blood sugars need initialed, filled out, etc. If state finds a hole in the MAR for insulin or a blood sugar, they can issue an Immediate Jeopardy tag. • Daily MAR audits will occur. If there are holes, disciplinary action will occur.
  • 6. Documentation Con’t • Any verbal order in the charts must have an MD or NP signature. If no signature, then no chart. Place in mailbox in med room that is designated for these. • On the MARs, the residents’ code statuses need to be on there. I hand wrote them in for July and I hope that Omnicare will put them on the August batch.
  • 8. More Documentation • There are now forms called “72 Hour Observation”. • This form is used for a Change of Condition. (ie: s/p fall, 911 being called with refusal to be transported, generalized complaints with an assessment and no new orders. • The regular Nurses’ Notes are for anything requiring longer than 72 hour documentation.
  • 9. Narcotic Count • All narcotics will be counted with the on- coming and off-going shifts every day. CNAs are witnessing in counting of the narcotics. • DO NOT forget to sign the count sheets.
  • 10. Coumadins • Make sure you are keeping track of any Coumadin changes on the form that is provided. • This is critical to complete…….
  • 12. Beginning in July • MARs and TARs will be in the same binder. • Our nursing staff will be responsible for completing the monthly weights and vital signs as we are no longer allowed to have hospice come in and do these. Our plan is to make an activity out of this. • All residents’ have to have a master signature log with their MARS. These will stay with them until they are discharged or deceased.
  • 13. Nursing No-Nos • We are not allowed to draw blood. • We are in the process of getting Med-Lab to come in and do our blood draws. • KDH will no longer be doing our blood draws. • We will let you know when this transition occurs. • When a resident goes out for a visit and meds need to be sent, you have to send the entire cards, bottles, etc. No more individual doses in envelopes. • There is a form for this.
  • 15. Nurses/ QMAs Please sign and date below stating that you have read and understood the content of this information. Detach this page and return to ALD. Name:___________Signature:______________ Title:__________ Date:__________