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Ski gear and winter gloves were optional yet clinical competencies were not during Naval Hospital Bremerton’s (NHB) Command Skills Fair held January 16 and 18, 2019.
With a winter ski resort theme, the focus of the event centered on educational, clinical skills refresher training on numerous ‘high risk, low volume’ duties, such as blood administration, malignant hyperthermia and neonatal resuscitation program protocol(s).
“Last year, following the Multi-Service Unit annual skills fair, Capt. Bailey, our Director of Nursing Services asked if we could reach further and make the next one a command wide approach. This event has been tailored towards nurses and hospital corpsmen that perform bedside care to patients either in an acute, clinic, or inpatient setting. There are also a few stations that hold valuable information for all staff, so it is worth everyone's time to come through to look and talk with the presenters,” said Lt. Cmdr. Candice Kline, Multi-Service Unit clinical nurse specialist and co-organizer of the event along with Lt. Cmdr. Sondra Jolly, Labor and Delivery clinical nurse specialist.
There was a host of static displays, information booths and practical application presentations, showcasing cardiac arrest response, obstetric emergency scenarios, along with other stations covering many aspects of a hospital setting, from safely evacuating patients, to understanding blood bank procedures, and even managing proper catheter placement.
“The organizers made it a multi-disciplinary and collaborative affair with our Nurse Corps officers leading the way. We also had other departments and disciplines involved. There were young hospital corpsmen demonstrating their deck plate leadership by sharing their knowledge with others, which is good for them and great for all of us. We have definitely upped our game. This event is really good,” added Capt. Johannes Bailey, NHB Director for Nursing Services.
How important is it for military treatment facility personnel – providers, nurses, corpsmen and support staff – to understand what ‘low-volume/high-risk indicates?
According to ‘Competency Assessment, A Practical Guide to the Joint Commission Standards’ (Third Edition), low-volume/high-risk duties are rarely performed duties that carry a significant risk of hazard or harm. Examples of such duties include a respiratory therapist stabilizing a premature infant for transport to a tertiary care neonatal intensive care unit, a nurse assisting with the insertion of a chest tube on a medical-surgical unit, and a staff member monitoring a patient receiving sedation for an invasive procedure.
One such station showcased how any staff member can do their part in handling an true emergency situation such as an adult or pediatric cardiac arrest, known as a Code Blue in hospital parlance.
Hospitalman Christopher Arocho, assigned to NHB’s Urgent Care Clinic, explained the workings of the defibrillator machine used to respond to a cardiac or respiratory arrest – known as a Code Blue in the hospital setting - going over basic instructions of the machine and correct placement of the pads.
“If there is an adult or pediatric Code Blue that someone answers, it’s really important to know the exact steps. The pads have their own instructions that are really helpful,” explained Arocho, describing the procedure to follow if someone discovers another suffering a cardiac or respiratory arrest; note the time, assess for unresponsiveness, check for carotid pulse, open airway, call for help or send another to report the situation to NHB’s Security, begin cardio pulmonary resuscitation (CPR) – including the difference between adult and pediatric - and continue performing CPR until other help arrives.
How important is it to get a refresher on being ready for a Code Blue emergency?
According to the American Heart Association, over 350,000 out-of-hospital cardiac arrests occur in the U.S. each year. Approximately 90 percent of those 350,000 don’t make it.
Statistical evidence shows that the more people who know how to render CPR when needed, especially in the first few minutes of cardiac arrest can double or triple that suffering person’s chance of survival.
CPR basics: For an adult, place your hands, one on top of another, in the middle of the person’s chest needing reviving. Push hard, push fast. The ratio is 30 chest compressions – 100 to 120 per minute – for every two breaths. The AHA has determined that hands-only CPR without breaths can help treat the victim, along with calling 9-1-1.
The AHA also notes that the person most likely to need CPR is actually someone known to them – imagine an elderly relative - with approximately 70 percent of out-of-hospital cardiac arrests taking place at home.
Hospital Corpsman 1st Class KC Geisler, laboratory technician, represented NHB’s Laboratory Department and Blood Bank and explained on the importance of blood administration and transfusion protocol.
“There are multiple checks involved, such as verifying the right patient receives the right unit, even before any providing any blood product, especially one needed in a timely manner for any transfusion. What most people don’t know is that the U.S. Food and Drug Administration regulates unit of blood used for transfusion. There is that heightened state of safety and technical safeguards in place which we closely follow,” said Geisler.
The event represented an expansion of the original ‘clinical competency review’ idea that Kline readily acknowledged could not have been held without the necessary support from across a wide spectrum of the command.
“We could not have done this without the great effort that all the clinics and departments that we have reached out to. We asked a lot of those departments. We greatly appreciate their effort to help make this a success,” Kline said, noting that it’s common for acute care nursing units to hold some type of skills fair or annual competency to brush up on clinical procedures.
“Many times the focus is on ‘high risk, low volume’ duties, meaning procedures that may have a lot of risk doing them that just are not done often, such as blood administration and transfusion protocol,” added Kline, citing that their goal was for each staff member to learned something new about patient care and brushed up on some skills, policies or procedures that they have not performed in a while.
“Clinical competency for all of us to always be ready is what it’s all about. That’s what we do and who we are,” Bailey stated.
| Date Taken: | 01.18.2019 |
| Date Posted: | 01.24.2019 11:53 |
| Story ID: | 308059 |
| Location: | BREMERTON, WASHINGTON, US |
| Web Views: | 1,026 |
| Downloads: | 1 |
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