Nursing

ANAPHYLAXIS EMERGENCY CARE - STANDARDIZED NURSING PROCEDURES *

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Tue, 05/29/2018
Revised: 
Fri, 01/12/2018

This procedure gives the RN the delegated authority to initiate appropriate care of the patient presenting with an anaphylactic reaction. Anaphylactic reactions are rare but life threatening. The timely use of Epinephrine, Benadryl and oxygen is critical to appropriate care of the patient.
Procedure
RN assesses patient and notes evidence of anaphylaxis. Percentages noted in parenthesis indicate likelihood of having this symptom as an indicator of impending anaphylaxis.
Evidence of developing anaphylaxis includes:

ANKLE AND FOOT X-RAY ORDERS - STANDARDIZED NURSING PROCEDURES

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Sat, 08/27/2011
Revised: 
Sun, 08/28/2011

This standardized procedure uses the Ottawa Rules for x-ray of the Ankle and the Foot as guidelines to allow the RN to order x-rays prior to clinician appointment when the patient meets the established criteria. In a meta-analysis, the Ottawa Rules for x-ray of the Ankle had a 97.6% sensitivity and reduced the unnecessary use of x-rays by 34%.
Procedure
RN orders x-ray of the ankle if the patient meets the following criteria
 Bone tenderness at posterior edge or tip of the lateral malleolus OR

b.) GENERIC FORMAT FOR STANDARDIZED NURSING PROCEDURES

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Fri, 08/19/2011
Revised: 
Thu, 10/06/2016

(developed based on CA Board of Registered Nursing, Title 16, CA Code of Regulations, section 1474)

The introduction to the Specialized Nursing Procedure section of the Nursing Manuel will specify the system by which the procedures are developed and reviewed, the criteria for periodic review, and the standards for continuing education. It will also state that all procedures are done only within the setting of the UCSC Student Health Center.

Procedure
Delineates each step in the procedure
 

a.) INTRODUCTION - STANDARDIZED NURSING PROCEDURES *

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Mon, 04/30/2018
Revised: 
Tue, 05/05/2015

The following standardized procedures outline the specific situations in which a Registered Nurse (RN) at the University of California, Santa Cruz Student Health Center may provide a patient with a prescription for a medication or initiate orders for labs or x-rays. The use of these procedures is limited to the UCSC Student Health Center. These procedures may not be used in any other setting.

ANAPHYLAXIS MEDICATION KITS *

Effective Date: 
Wed, 09/15/2004
Reviewed: 
Wed, 02/21/2018
Revised: 
Wed, 11/08/2017
Policy: 

Medication exchange kits are provided by pharmacy to areas outside the pharmacy, per the medical director.

Procedure: 

The pharmacy pre-prepares anaphylaxis medication exchange kits for areas outside the pharmacy.
These kits are sealed by pharmacy with break-away locks.
Once a kit has been opened and used in the Student Health Center, the nursing staff brings the open kit to the pharmacy for immediate exchange for a new kit.
This ensures that medications used from the kit for treatment are available and fully stocked at all times.
The pharmacy restocks and locks the kit and documents the nearest expiration date on the outside of the box.
Clinical staff will bill for use of Epi-Pen.

KIT LOCATIONS:
West Wing Floor 1:  Treatment Rooms, Nurses Station, Red Cart
West Wing Floor 2:  AIT, Nurse Appointments, Nurses Station, Treatment Rooms

 

Key Points: 
  • Exchange kits are provided throughout the SHC for urgent treatment of anaphylaxis.
  • Opened kits are returned to pharmacy for immediate replacement.

SPIROMETRY PROCEDURE

Effective Date: 
Thu, 04/01/2004
Reviewed: 
Mon, 08/29/2011
Revised: 
Fri, 10/26/2012

SUBJECT: SPIROMETRY PROCEDURE

PERSONNEL: RN, LVN, MA  currently certified and trained by the NIOSH Approved Spirometry Testing and Respiratory Surveillance Training Program

EQUIPMENT: Renaissance Spirometry System

AUTOCLAVE: AUTOCLAVE OPERATIONS *

Effective Date: 
Fri, 04/01/2005
Reviewed: 
Mon, 04/16/2018
Revised: 
Thu, 05/07/2015

SUBJECT: AUTOCLAVE OPERATIONS

PERSONNEL: RN, LVN, MA

EQUIPMENT: MIDMARK RITTER M11 ULTRACLAVE AUTOCLAVES

PROCEDURE: REFER TO THE OPERATION MANUALS FOR INSTRUCTIONS

Only those individuals orientated to the autoclave may operate the autoclave.

Precautions: Sterilizer chamber may be hot, use caution when loading and unloading sterilizer and in general when operating the sterilizer.

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