STRATEGIES FOR PROFESSIONAL PRACTICE: UNIT two II: TIME MANAGEMENT C: SETTING PRIORITIES.
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Transcript of STRATEGIES FOR PROFESSIONAL PRACTICE: UNIT two II: TIME MANAGEMENT C: SETTING PRIORITIES.
SETTING PRIORITIESSETTING PRIORITIES• To plan effective use of time, nurses must understand the
“big picture.”
• No nurse works in isolation:
• Nurses should know what is expected of their – Cooworkes– What is happening on the other shifts– What is happening in the agency– What is happening in the community
PRIORITY SETTINGPRIORITY SETTING How do you set priorities for each patient?
What strategies will you use to priority set for each patient?
What parts of your data will help you set priorities for each patient?
EXAMPLES OF IMPACT OF BIG EXAMPLES OF IMPACT OF BIG
PICTURE ON NURSEPICTURE ON NURSE
If the previous shift nurses were stressed by a crisis, the next shift may not get started smoothly
If areas outside of the unit are overwhelmed, a nurse/tech might be moved to assist on the overwhelmed unit
When nurses take the “big picture” into consideration, they are less likely to be frustrated when asked to assist others
The nurse can then build into their time management plan the possibility of giving and receiving assistance
CRITICAL PROBLEMSCRITICAL PROBLEMS How do you determine you have a critical
problem?
What do you do with your plan of care at this point?
What characteristic is necessary in the caregiver to make critical problems bearable?
FIRST PRIORITY: LIFE THREATENING FIRST PRIORITY: LIFE THREATENING
PROBLEMS WITH ABC’SPROBLEMS WITH ABC’S
Pt whose condition is life-threatening is the highest priority and requires monitoring until transfer or stabilization These can occur at any time during the shift and may or
may not be anticipated
ABC’S. Remember Maslow’s Hierarchy of Needs.
See high-priority unstable patients who have threats to their ABCs (airway, breathing, and circulation) These patients require nursing assessment, judgment,
evaluation until transfer or stabilization Monitor equipment and assess observations used to
support the status of patient’s ABCs
SECOND PRIORITY: SECOND PRIORITY: SAFETYSAFETY
Ask yourself:
Are there any threats to patient safety and security such as threats of violence, need for fall prevention, infection control
See these patients next
THIRD PRIORITY: THIRD PRIORITY:
Comfort, Teaching and other needsComfort, Teaching and other needs
Assess the patients’ other needs and prioritize using Maslow’s hierarchy.
May include love and belonging, self-esteem, and self-actualization
WHO IS SEEN LAST? WHO IS SEEN LAST? Stable pts
who need standard, unchanging procedures and have predictable outcome are seen last
TOP PRIORITY PATIENT TOP PRIORITY PATIENT CARE GROUPS: CARE GROUPS:
respiratoryrespiratory
Airway compromise
Severe respiratory distress, indadequate breathing
Critical asthma
Chest trauma with respiratory distress
TOP PRIORITY PATIENT CARE GROUPS:TOP PRIORITY PATIENT CARE GROUPS:
Cardiovascular and NeurologicalCardiovascular and Neurological
CARDIOVASCULAR
• Cardiac arrest
• Shock or hypotension
• Ex-sanguinating hemorrhage
NEUROLOGICAL
• Major head injury
• Unconscious or unresponsive
• Active seizure state
TOP PRIORITY PATIENT CARE GROUPS: TOP PRIORITY PATIENT CARE GROUPS:
Musculoskeletal and SkinMusculoskeletal and Skin
MUSCULOSKELETAL
Major trauma
Traumatic amputation –extremity
Major cold injury – hypothermia
SKIN
Burn, greater than 25% body surface area (BSA) or airway involvement
TOP PRIORITY PATIENT TOP PRIORITY PATIENT CARE GROUPS: Gastrointestinal and CARE GROUPS: Gastrointestinal and
GynecologGynecologicalical
GASTROINTESTINAL
Difficulty swallowing with airway or respiratory compromise
Abdominal trauma
Penetrating or blunt
GYNECOLOGICAL:
Vaginal bleeding, patient with abnormal vital signs
TOP PRIORITY PATIENT CARE GROUPS: TOP PRIORITY PATIENT CARE GROUPS:
/Immunologic/Endocrine/Infection/Child or Elder /Immunologic/Endocrine/Infection/Child or Elder
AbuseAbuse
IMMUNOLOGIC:
• Anaphylaxis
ENDOCRINE
• Hypoglycemia – altered consciousness
INFECTION
• Septic shock
CHILD OR ELDER ABUSE:
Unstable situation or conflict