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CS310
At Arm’s Length: ICU Quick Reference Cards
By: G. Corliss, & C. Brochu; Dartmouth Hitchcock Medical Center; Lebanon, NH
For further information, please contact: kgcorlis@comcast.net
Purpose: The ICU at Dartmouth-Hitchock Medical Center has had a large influx of new graduate nurses and nurses without ICU experience. The goal of this project was to decrease the stress of the new R.N. by providing them readily available reference tools to use during critical patient events.
Description: The nursing climate today requires a high percentage of nurses without critical care experience to be hired into critical care. A vast amount of information must be acquired during the orientation process to function safely and efficiently at the bedside. Through observation of nurses during stressful clinical situations in the simulation lab and at the bedside, the educators noticed an inordinate amount of time being spent looking up information on vasoactive drips and reading hemodynamic waveforms. We created Quick Reference Cards that are small enough to be attached to their mandatory ID tags.The most frequently used card is the IV Drip Reference Sheet. It lists drugs by generic and trade name, the usual dose range, whether the drug is weight based, whether it is mcg, mg or units, and whether the rate is per minute or hour. During a crisis at the bedside the nurse is able to take this information from the card that is immediately availabe on their name tag, and program a drug calculating pump without having to look for a reference book or sheet elsewhere. Additional quick reference cards have been developed on arrhythmia identification,room set up and hemodynamic monitoring (ECG correlates and normal values).
Evaluation and Outcomes: Nurses are visibly less stressed during a crisis and use these reference cards on a daily basis. Errors in IV pump programming have decreased. Experienced nurses ask for the reference cards as well! Due to the popularity of these cards, they are provided for all new staff, regardless of experience. Other critical care units have expressed an interest in utilizing the quick reference cards and copies are available from our ICU website.
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