Week 1: CC environment

Question 1

Best “level” for hospital and NICU

Answer 1

Level 1 hospital: good. Teaching hospital with multiple care pathways and can handle multiple patients.

NICU: level 3 is the best

Question 2

Open critical care unit

Answer 2

• multiple staff is coming and going, physicians, ancilary staff, nurses, all managing a patient
• most typically used

Question 3

closed unit (ICU)

Answer 3

certain staff including an intensivist who managed your patient. Great, unless the intensivist missing something, or something special happens that’s not in the intensivists realm of specialty.

Question 4

Biggest problems for critical care patients

Answer 4

• they are vulnerable
• communication issues
• technology
• complex, multiple-step process

Question 5

SBAR with another R

Answer 5

Situation, background, assessment, recommendation, and don’t forget to recite it back

Question 6

Two rule challenge

Answer 6

if you call the provider and you don’t get a reasonable solution, restate what you think is approrpriate, restate why you think it’s appropriate, and if you still don’t get what you need, contact another provider

Question 7

Who makes national patient safety goals

Answer 7

Joint Commission

Question 8

VAP bundle

Answer 8

prevent ventilator associated pneumonia

*head of bed elevated 30

*oral care every 2 hours

*turn Q2

*sedation vacation every 24 hours

*peptic ulcer prphylaxis within the first 24 hours of mechanical ventilation

*DVT thrombosis w/i 24 hours on vent

Question 9

CLABSI Bundle

Answer 9

prevent central-line associated blood stream infection

Question 10

ABCDE Bundle

Answer 10

improved cognitive and functional outcomes for ICU survivors
-A: airway B: breathing C:coordination D: delirium monitoring E: exercise/early mobility

Question 11

Sepsis Bundle

Answer 11

prevent sepsis & septic shock

Question 12

The Safe Medical Device Act

Answer 12

• Require that hospitals report serious or potentially serious device-related injuries to the U.S. Food and Drug Administration (FDA).
• All implantable devices must be documented and tracked with the FDA.

Question 13

Moral Distress
AACN 4 A’s

Answer 13

• When you’re in a facility and the policies prevent you from doing what you know needs to be done
• Ask
• Affirm
• Assess
• Act

Question 14

Conscientious Refusal

Answer 14

• Personal Moral standard
• Rightness/wrongness
• Personal Sanction

Question 15

Compassion Fatigue

Answer 15

• Intrusive Thoughts
• Blending of Roles
• Lowered Tolerance
• Dread
• Depression
• Self-destructive Actions
• Hyper-vigilance
• Decreased Functioning
• Loss of Hope