Personal Practice Environment
In the acute care setting, such as the emergency department and the medical-surgical unit, patient acuity varies, but the need to provide a safe care setting remains. Recently, patient acuity has increased, demanding evidence-based practices for safe health care delivery. Currently, I practice in both, the emergency department and the medical-surgical unit, with a wide variety of patient conditions including, but not limited to: trauma, post-operative, renal, cardiac, diabetic, and altered level of consciousness.
Nursing staff in the medical-surgical (M/S) unit includes registered nurses, licensed practical nurses, and certified nursing assistants. Nursing staff in the emergency department (ED) includes registered nurses and ED technicians. While the daily patient census varies, the average ED daily census is 75 to 100 patients, and the average daily M/S census is 20 to …show more content…
The primary nurse notifies the attending physician and the shift leader, and the shift leader notifies the house supervisor and the unit manager. Immediate actions are taken to correct the situation, if applicable. Follow-up practices include a system improvement report (SIR), post-fall huddle, pharmacy double-check, or a root cause analysis meeting. The top three practice errors reported in the M/S setting are late or missed medications, incomplete surgery questionnaires, and incomplete charting. The top three practice errors in the ED setting are missed medications, improper medication administration routes, and incomplete