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Important message from Dr Joseph Seaman - Chief of Staff

 

Spring 2019 Edition

Download Print Version Here

Thank you for helping things run smoothly during the season with our consistent high census! Your flexibility and dedication is appreciated!

Credentialed Staff Secondary ID BADGES- Now available for pick up

Medical Staff Services office M-F 8am-4pm, 3rd Floor East Tower next to Medical Staff Lounge
All SMH staff and volunteers are to wear a secondary ID badge which is for idendifcation purposes only. This new badge is to be used in tandem with your primary or proxy access badge and is to be placed on the opposite side of the proxy badge. The purpose for this additional badge is to ensure we are identifiable by name and picture at all times even when our badge flips over. 
If you have any questions or concerns, please reach out to Public Safety at 941-917-1283.

Data Security Concerns

Due to recent security concerns, IT leadership is encouraging all staff to change their domain password. This is the same password used for email. To change your password hit Ctrl + Alt + Del

EMR Cloning a.k.a. Copy & Pasting

Copying and pasting from day to day can be associated iwth misleading or incorrect information being documented. Cloning previously recorded information from a prior note into a new note is a problem in health care institutions that is not broadly addressed. 

The medical record must contain documentation showing the differences and the needs of the patient for each visit or encounter. Simply changing the date on the EHR without reflecting what occurred during the actual visit is not acceptable. 

Here is a link to CMS for more information regarding the Electronic Health Record: Click Here

Chart completion questions? Call (941) 917-1119

EMR Community Allergies and Community Medications 

Community Allergies and Community Home Medications are now populating within the patient record in SCM. 

What does this mean?

  • If a physician office sends SMH a "Community Document" known as a CCDA, it will populate the Allergies and Home Medications that are on file for the patient in the physician office. Nursing will be able to see these community entries when doing allergey review and medication review. They can either choose to accept or deny them based on what the patient states during the admission process. 
  • Care providers will notice that the Allergies that were already Verified will now appear Pending Approval.
     

Ordering Pain Consults 

Consults for acute pain team should include information or consult origination, collaboration instructions and reason for the consult.

  1. Who is requesting the consult a nurse or prescriber?
  2. Who should pain team collaborate with? An Ordering Prescribed (will be automatically selected if this is a nurse generated consult) OR the Acute Pain Medical Director (Dr. Pereira)
  3. What is the reason for the consult (be as specific as possible)

 

Order Set for Alcohol Withdrawal Updated

The pilot found improved identification of patients at highest risk of developing alcohol withdrawal through utilization of the PAWSS assessment. Scheduled tapering doses of benzodiazepines in qualifying patients were found to be a safe and effective treatment regimen. A pilot study was conducted on 7ET and 5WT from August to December 2018 to assess: 

  • Risk stratification through a Prediction of Alcohol Withdrawl Severity Scale (PAWSS) assessment. PAWSS is a 10-point scale shown to have a sensitivity of 93.1% and a specificity of 99.5% in predicting severe alcohol withdrawal in patients who score a 4 or higher.
  • Use of scheduled tapering doses of benzodiazepines in patients at highest risk of withdrawal. Diazepam 10mg or lorazepam 2mg Q6h X4 doses, Q8h X3 doses, Q12h X2 does
  • Safety of using diazepam as the primary benzodiazepine in patients without liver disease. Defined as: cirrhosis, elevated AST/ALT (3XULN) or liver failure.

 

Example of Alcohol Withdrawal Order Set

1. Diazepam is now the default medication

  • Exceptions: 
              - IV Use: Lorazepam IV 
              - Lorazepam PO/IV in patients with cirrhosis, elevated AST/ALT (3XULN) or liver failure due to half-life prolongation


2. Prescribers must answer two questions to select the appropriate scheduled and prn medications: 

  • Is the patient strict NPO?
  • Does the patient have liver dysfunction/cirrhosis/elevated AST/ALT?


3. Patients now placed on scheduled tapering doses of diazepam (or lorazepam) for a PAWS score greater than or equal to 4.

 

Pedestrian Safety- Campus Construction (see map)

Construction of the new oncology tower is getting underway. Staff should avoid using the sidewalk that runs from outside the Departure Lounge to Waldemere Street whenever possible to avoid potential construction dust and noise. 

  • Staff who need to cross Waldemere street should use the pedestrian bridge, which runs from the third floor of the hospital to the second floor of the Waldemere Medical Plaza. 
  • Pedestrians also may enter or exit the Waldemere Garage via the pedestrian ramp located on the north side of the garage, and follow the yellow striped walkway through the first floor of the garage to the valet waiting area and A elevators. 
  • All pedestrians crossing Waldemere Street via the ground level should be sure to use the crosswalk.
  • Valet vehicle retrieval for cars dropped off at the main entrance has moved to the Waldemere Garage. A new valet office has opened across from the Departure Lounge on the first floor of the hospital and a valet waitig area is now open near the A elevators. (Arlington Street and Emergency Care Center valet drop-off/pick-up has not changed.)

 

Thank you all for protecting our patients and team members

Joseph Seaman, MD
Chief of Staff