7/25/2014 Kudos on your tip sheet emails - Davis, Aurora

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Kudos on your tip sheet emails
As per our discussion this morning, I wanted to officially recognize how helpful I have found the tip sheet
emails you send all nursing staff clarifying and elaborating on often misunderstood, missed, or just little
known facts pertaining to our policies, procedures, and nursing practice on the floor. Even though I am a
relatively seasoned RN on the floor, I still read them in earnest, and always find I walk away having
learned or been reminded of something I may have forgotten, or just never have learned in the first place.
I think your contribution in this way is doing much to raise the standard of care and the awareness of best
care practices on the floor. At a time when so many of our staff is new or new to our facility, this is of
great service to all of us, even old crones like me! Kudos to you for going above and beyond to educate
your colleagues and reduce errors in care delivery!

Yeah Aurora!!

Anne Lacelle, RN, BSN, OCN
Relief Charge Nurse
Oncology and Bone Marrow Transplant
Anne.Lacelle@uchealth.org
Lacelle, Anne
Fri 5/16/2014 12:47 PM
To:Davis, Aurora <Aurora.Davis@uchealth.org>;
7/24/2014 Re: Learning Opportunities #3 - Davis, Aurora
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Re: Learning Opportunities #3
Great info, thanks!
On May 15, 2014, at 10:49 AM, "Davis, Aurora" <Aurora.Davis@uchealth.org> wrote:
Rockstars,

What? More learning opportunities?!? Oh, the fun never stops on BMT and OMG. There's
always something new to learn. Here is Round #3 of Aurora's Ambitiously Annoying and
Alliterative Admonitions.

1) Don't give BMT cell premeds until you know when cells are to be given. These premeds
are usually timed for 0900, but they should not be given until 30 minutes before the stem cells
are to be infused (per the admin instructions). As the nurse giving the cells, its your job to call
the stem cell lab and find out what time cells are going to be infused. When in doubt, talk to
the charge nurse; they'll help you figure it out. (This also goes for the pre-hydration, which
needs to be timed for 2 hours before the cell infusion begins.)

2) When you complete the yellow form 24H post stem cell infusion and fax it to the stem
cell lab, you must document that you are the evaluator and whether or not the patient
had a reaction. If the patient had no reaction, check the box next to "no adverse reaction in
24 hours", otherwise you should indicate what kind of reaction the patient had and how it was
treated. Even if the form is to be faxed tomorrow, if the patient reacts on your shift, you
should still mark it down on the yellow form so that the RN faxing the form doesn't have to
play detective. Side Note: the form doesn't have to be faxed precisely 24 hours after infusion,
there's a little leeway so that you can complete the form appropriately. As long as you fax it
by the end of your shift, you're good to go. Also of note: The stem cell lab says our compliance
rate on sending these forms has improved, but people are still forgetting to initial the
evaluator line. If you're the pt's RN and you fax the form, then YOU are the evaluator, so don't
forget to initial it.

3) We should not be using most dialysis caths on the floor, but Marhurker caths are an
exception. Most of the time, we CANNOT use dialysis cathethers on the floor. Only dialysis
nurses can access dialysis caths, change their dressings, or generally do anything with them.
There is one exception: Marhurker triple lumen central lines, used for apheresis and dialysis.
These are noticably different looking from "regular" dialysis caths in that, in addition to the
two yellow Tego caps, there is a third lumen on the line. The third lumen is longer, thinner,
Maher, Stephani M
Thu 5/15/2014 11:11 AM
To:Davis, Aurora <Aurora.Davis@uchealth.org>;
7/24/2014 RE: Learning Opportunities #3 - Davis, Aurora
https://pod51038.outlook.com/owa/#viewmodel=ReadMessageItem&ItemID=AAMkADJmODRkNzU1LWY2MDAtNGYwYS1hZDViLWQ2ZWI2ZDg0NDEyMwBG 1/3
RE: Learning Opportunities #3
Fantastic work, Aurora!

An incredibly engaging and clever way to implement a "solution"- just as we spoke about :-)

Renee M. Abdella, BSN, RN
Oncology / Bone Marrow Transplant
Co-Chair Staff Nurse Council
University of Colorado Hospital
(c) 508-615-0532
From: Davis, Aurora
Sent: Thursday, May 15, 2014 10:49 AM
To: UCH-AIP 11th Onc RN
Subject: Learning Opportunities #3

Rockstars,

What? More learning opportunities?!? Oh, the fun never stops on BMT and OMG. There's always
something new to learn. Here is Round #3 of Aurora's Ambitiously Annoying and Alliterative Admonitions.

1) Don't give BMT cell premeds until you know when cells are to be given. These premeds are usually
timed for 0900, but they should not be given until 30 minutes before the stem cells are to be infused (per
the admin instructions). As the nurse giving the cells, its your job to call the stem cell lab and find out
what time cells are going to be infused. When in doubt, talk to the charge nurse; they'll help you figure it
out. (This also goes for the pre-hydration, which needs to be timed for 2 hours before the cell infusion
begins.)

2) When you complete the yellow form 24H post stem cell infusion and fax it to the stem cell lab,
you must document that you are the evaluator and whether or not the patient had a reaction. If the
patient had no reaction, check the box next to "no adverse reaction in 24 hours", otherwise you
should indicate what kind of reaction the patient had and how it was treated. Even if the form is to be
faxed tomorrow, if the patient reacts on your shift, you should still mark it down on the yellow form so that
the RN faxing the form doesn't have to play detective. Side Note: the form doesn't have to be faxed
precisely 24 hours after infusion, there's a little leeway so that you can complete the form appropriately.
As long as you fax it by the end of your shift, you're good to go. Also of note: The stem cell lab says our
compliance rate on sending these forms has improved, but people are still forgetting to initial the
evaluator line. If you're the pt's RN and you fax the form, then YOU are the evaluator, so don't forget to
initial it.
Abdella, Renee M
Thu 5/15/2014 11:33 AM
To:Davis, Aurora <Aurora.Davis@uchealth.org>;