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standard work : Controlled Substance - Patients Going to SAS from Acute, IMU, and ED with PCA Pumps

Standard Work for Patients Going to SAS from Acute, IMU, and ED with PCA Pumps (questions, Clara Winfield)

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  1. effective date:

    December 4, 2017
  2. content:

    Standard Work   for Patients Going to SAS from Acute,   IMU, and ED with PCA Pumps

     

    Last updated:  12/4/17

    Owner: Clara Winfield

    Performed By:  Acute Care Unit/IMU, SAS and PACU nurses; Anesthesia provider

    Version:  1.0

    Revised by:  

    Trigger:  Identified need for   proper hand-off of PCA narcotic to ensure chain of custody

    Scope (who?):  Patients coming   from acute care units, IMU, ED  with   PCA to SAS for surgery

    Standard Work Outline

     

    Work   Performed by (when):

    Major   Step

    Details

    Importance

    Expected   Outcome

    1

    Pre-op:

    SAS nurse

    Obtain hand-over of care

    Will call for hand-over from acute care/IMU/ED  

     

     

    3

    Acute care unit/IMU/ED nurse prior to patient transfer to SAS

     

    Documents in MAR remaining volume in “Rate/Dose/Verify”

     Clears pump before transferring patient

    Ensures accountability of narcotic

    Follow existing SW for “Controlled   Substance PCA transfer

    4

    SAS nurse

     

    Receives patient in SAS from acute care unit/IMU/ED

     Documents in MAR remaining volume and current settings (rate, volume   infused, and volume remaining in “Rate/Dose/Verify”

    Ensures accountability of narcotic

    Chain of custody of narcotic maintained from acute care unit/IMU/ED   to SAS

    5

    SAS nurse

    and

    Anesthesia provider (CRNA, resident)

    Patient transport to OR

    Prior to transport to OR, SAS nurse caring for patient (or charge   nurse if primary nurse unavailable) will document in MAR remaining volume in   “Rate/Dose/Verify”

     Clears pump

     Anesthesia provider accepts PCA with patient to OR

    Ensures accountability of narcotic

    Chain of custody of narcotic    maintained from SAS nurse to anesthesia provider and while patient is   in the OR

    6

    Anesthesia provider (CRNA, resident)

    and

    PACU nurse

    Patient transfer out of OR to PACU

    If PCA will be restarted postoperatively: Anesthesia provider takes   PCA with patient to PACU if PCA to be re-initiated post-op

     PACU nurse documents in MAR remaining volume and current settings   (rate, volume infused, and volume remaining in “Rate/Dose/Verify”

     If PCA will not be restarted postoperatively:

    Anesthesia provider to conduct waste of PCA narcotic in PYXIS if PCA will   not be continued postoperatively

    Ensures accountability of narcotic

    Chain of custody of narcotic is transferred from Anesthesia provider   to PACU nurse

     

    Follow existing SW for “Controlled   Substance PCA Wasting

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