TISS28 collection Survey January 7, 2013: Difference between revisions

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*''' MICU and my IICU patients only''' I have the following comments:

*The staff of MICU are doing the TISS for the most part.They have always been pretty good but miss certain elements.The educators Joanne Hutton and Maurita Keisman have been really supportive.

*The staff of MICU are doing the TISS for the most part. They have always been pretty good but miss certain elements. The educators Joanne Hutton and Maurita Keisman have been really supportive.

* ~~The~~ last day in unit continues to often not be filled in.

*'''DISCHARGE DAY'''- the last day in unit continues to often not be filled in.

* Diuretics are missed completely or they are counting oral doses.~~They~~ are filling in diuretics not at the listed doses.

*'''#31 Diuretics''' are ''missed completely or they are counting oral doses''. Staff are filling in diuretics that are not at the listed doses.

* I had a few patients that came in between 22:00 and 24:00 and the staff used the old 2 hour rule.

*'''DAY 1 TISS''' - I had a few patients that came in between 22:00 and 24:00 and the staff used the old 2 hour rule.

* Some confusion seems to be occurring regarding the CRN's filling in the line counts. Some think they don't need to do it anymore, some think they do.I will try to go this week to check IICU and follow up on who their educator is.On December 31 a staff member told me they do not have an educator anymore.Their educator is Sarah from SICU. Dave was not sure why the staff would say they don't have and educator.

* Some confusion seems to be occurring regarding the CRN's filling in the line counts. Some think they don't need to do it anymore, some think they do.I will try to go this week to check IICU and follow up on who their educator is. On December 31 a staff member told me they do not have an educator anymore. Their educator is Sarah from SICU. Dave was not sure why the staff would say they don't have and educator.

**'''CRN's are to continue with line count form until they are notified by their manager to stop. I have email the managers today.''' -[[User:TOstryzniuk|Trish Ostryzniuk]] 17:38, 2013 January 9 (EST)

*'''4 Meds any route''' -oral meds only are missed occasionally as a medication ''any route''.[[User:GHall|GHall]] 17:26, 2013 January 10 (EST)

*'''#9-CAM +''' is new and perhaps I need more education. Here is some valuable info I got from Maurita

**Yes, should be done/documented every shift, or q12h.

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**Is supposed to be charted on the neuro section of the flowsheet and the systems review. It should be CAM +, CAM - or unable to assess (due to therapeutic sedation etc).

*''Can we get some education on how the staff determine this scale and how it is supposed to be charted?'' Or maybe I will see what they got for info and post it

*people are counting points for ~~just~~ intake and output when the patients did not have vital signs for 2 hours.~~It doesn't say or it says and~~

*'''#2 - people are counting points for ONLY intake and output when the patients did not have vital signs for 2 hours.

*'''#46 ~~lines at 2300 hrs~~''' are ~~occasionally~~ missed. So far I have corrected them.

*'''#46-49 - The 23:00 hour questions''' are often missed,it's almost like they think they answered the questions already on the form. So far I have corrected them.

**''What about permanent tunnelled lines do they count?''

***'''CRN's are to continue with line count form until they are notified by their manager to stop. I have email the managers today.''' -[[User:TOstryzniuk|Trish Ostryzniuk]] 17:38, 2013 January 9 (EST)

*''What about permanent tunnelled lines do they count?''

*oral meds only are missed occasionally as a medication any route.[[User:GHall|GHall]] 17:26, 2013 January 10 (EST)

*'''DISCHARGE DAY''': The no tiss elements were not being filled in when a patient was transfer ready because of the description on the guidelines given to staff. They thought because the patient was transfer ready the tiss elements did not count.

*'''#6-dressing''' ''for lines'' are missed

*'''#6-dressings''' ''for decubitus'' are missed

*'''#8- Drainage tubes: foley is not being included as a drainage tube.

*'''#8- Drainage tubes''': ''foley is not being included'' as a drainage tube.

*'''#39 - emergency surgery''' is being '''double counted''' for '''gi scope/embolization'''

*'''#39 - emergency surgery''' is being ''double counted'' for ''gi scope/embolization''

*'''46-49 - The 23:00 hour questions''' are often missed,it's almost like they think they answered the questions already on the form

*staff are writing on the form still, I'm constantly erasing.

*staff are writing on the form still, I'm constantly erasing

*'''#39 emerg surgery'''- staff are ''counting angios as emergency surgery''

*'''#39 emerg surgery'''- ~~They~~ are '''counting angios as emergency surgery'''

**thank you Gail. Better yet, please email observations to Shelley, Basil Evan & Maurita.-[[User:TOstryzniuk|Trish Ostryzniuk]] 19:28, 2013 January 25 (EST)

@@ Line 17: / Line 17: @@
 *''' MICU and my IICU patients only''' I have the following comments:
-*The staff of MICU are doing the TISS for the most part.They have always been pretty good but miss certain elements.The educators Joanne Hutton and Maurita Keisman have been really supportive.
+*The staff of MICU are doing the TISS for the most part.  They have always been pretty good but miss certain elements. The educators Joanne Hutton and Maurita Keisman have been really supportive.
-* The last day in unit continues to often not be filled in.
+*'''DISCHARGE DAY'''- the last day in unit continues to often not be filled in.
-*  Diuretics are missed completely or they are counting oral doses.They are filling in diuretics not at the listed doses.
+*'''#31 Diuretics''' are ''missed completely or they are counting oral doses''. Staff are filling in diuretics that are not at the listed doses.
-* I had a few patients that came in between 22:00 and 24:00 and the staff used the old 2 hour rule.
+*'''DAY 1 TISS''' - I had a few patients that came in between 22:00 and 24:00 and the staff used the old 2 hour rule.
-* Some confusion seems to be occurring regarding the CRN's filling in the line counts. Some think they don't need to do it anymore, some think they do.I will try to go this week to check IICU and follow up on who their educator is.On December 31 a staff member told me they do not have an educator anymore.Their educator is Sarah from SICU.  Dave was not sure why the staff would say they don't have and educator.
+* Some confusion seems to be occurring regarding the CRN's filling in the line counts. Some think they don't need to do it anymore, some think they do.I will try to go this week to check IICU and follow up on who their educator is.  On December 31 a staff member told me they do not have an educator anymore.  Their educator is Sarah from SICU.  Dave was not sure why the staff would say they don't have and educator.
+**'''CRN's are to continue with line count form until they are notified by their manager to stop.  I have email the managers today.''' -[[User:TOstryzniuk|Trish Ostryzniuk]] 17:38, 2013 January 9 (EST)
+*'''4 Meds any route''' -oral meds only are missed occasionally as a medication ''any route''.[[User:GHall|GHall]] 17:26, 2013 January 10 (EST)
 *'''#9-CAM +''' is new and perhaps I need more education. Here is some valuable info I got from Maurita
 **Yes, should be done/documented every shift, or q12h.
@@ Line 27: / Line 29: @@
 **Is supposed to be charted on the neuro section of the flowsheet and the systems review.  It should be CAM +, CAM - or unable to assess (due to therapeutic sedation etc).
 *''Can we get some education on how the staff determine this scale and how it is supposed to be charted?''  Or maybe I will see what they got for info and post it
-*people are counting points for just intake and output when the patients did not have vital signs for 2 hours.It doesn't say or it says and
+*'''#2 - people are counting points for ONLY intake and output when the patients did not have vital signs for 2 hours.
-*'''#46 lines at 2300 hrs''' are occasionally missed. So far I have corrected them.
+*'''#46-49 - The 23:00 hour questions''' are often missed,it's almost like they think they answered the questions already on the form. So far I have corrected them.
-**''What about permanent tunnelled lines do they count?''
+{{Discussion}}
-***'''CRN's are to continue with line count form until they are notified by their manager to stop.  I have email the managers today.''' -[[User:TOstryzniuk|Trish Ostryzniuk]] 17:38, 2013 January 9 (EST)
+*''What about permanent tunnelled lines do they count?''
-*oral meds only are missed occasionally as a medication any route.[[User:GHall|GHall]] 17:26, 2013 January 10 (EST)
 *'''DISCHARGE DAY''': The no tiss elements were not being filled in when a patient was transfer ready because of the description on the guidelines given to staff.  They thought because the patient was transfer ready the tiss elements did not count.
 *'''#6-dressing''' ''for lines'' are missed
 *'''#6-dressings''' ''for decubitus'' are missed
-*'''#8- Drainage tubes:  foley is not being included as a drainage tube.
+*'''#8- Drainage tubes''':  ''foley is not being included'' as a drainage tube.
-*'''#39 - emergency surgery''' is being '''double counted''' for '''gi scope/embolization'''
+*'''#39 - emergency surgery''' is being ''double counted'' for ''gi scope/embolization''
-*'''46-49 - The 23:00 hour questions''' are often missed,it's almost like they think they answered the questions already on the form
+*staff are writing on the form still, I'm constantly erasing.
-*staff are writing on the form still, I'm constantly erasing
+*'''#39 emerg surgery'''- staff are ''counting angios as emergency surgery''
-*'''#39 emerg surgery'''- They are '''counting angios as emergency surgery'''
 **thank you Gail.  Better yet, please email observations to Shelley, Basil Evan & Maurita.-[[User:TOstryzniuk|Trish Ostryzniuk]] 19:28, 2013 January 25 (EST)