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June 12, 2015

Nurse Catch Prevents Patient Harm

By Kris Schanilec

349899_0002Nurse Catch Prevents Patient Harm

Michelle Tellier, Nurse in Cardiac Catheterization Laboratory (Cath Lab) at Mayo Clinic Hospital — Rochester, caught patient morphine allergy when applying safety checks and her “What’s my 5?” approach to taking personal responsibility for patient safety.

Nurse catches morphine allergy, prevents harm by Kris Schanilec 

Michelle Tellier is among 31 nurses in the Cardiac Catheterization Laboratory (Cath Lab) at Mayo Clinic Hospital — Rochester. They cover 14 job roles, from checking in patients to monitoring procedures and discharging or admitting patients to the hospital. It is a fast-paced environment with frequent practice changes.

All the more reason to use safe behaviors like "pay attention to detail," "communicate clearly" and "support each other," says Tellier. “You should never cut corners; you should always do the final pause and verification. Even if multiple people have checked, you should always be personally responsible for your patient’s safety."

It was during one of these checks recently that Tellier caught a morphine allergy. Even though employees already had questioned the patient, he had not disclosed his allergy. Tellier updated the electronic health record and printed a new patient armband to alert the care team; morphine is sometimes used during Cath Lab procedures.

Thanks to Tellier, this patient was spared the risk of a life-threatening allergic reaction, and her good catch was shared in employee meetings to help keep future patients safe.

The safety culture is strong in the Cath Lab, where all 150 employees use the Team-based Engagement Model. They recently implemented a standard, more inclusive preprocedural briefing process.

 

“What’s my 5?”
By Michelle Tellier

1. Pay attention to detail
You should never cut corners; you should always do the final pause and verification. Even if multiple people have checked, you always should be personally responsible for your patient’s safety.

2. Have a questioning and receptive attitude
During the preprocedural pause, we’re all expected to listen and question anything we’re not familiar with or not sure of. We do a great job of this. Physicians are very open to having us ask questions and relay information to them.

3. Communicate clearly
I always ask patients to verify information in their own words. I don’t just say, “These are your allergies, yes or no?” I don’t ever put words in their mouth, because I always get a better answer if I just let them talk.

4. Hand off effectively
We always give a nurse-to-nurse handoff in the recovery room, and if anything outside the norm needs to be reported to the floor, the recovery nurse will call the floor nurse to give a report. The most common complications we call about are bleeding complications at the procedure site, continued nausea and severe pain issues.

5. Support each other
When there is an issue in the procedure room, I am able to call the charge nurse and immediately get help. That’s how it is every day. You can call someone, and they’ll help you. If we need anything from Anesthesiology, within seconds, they’re right there to help us.

Tags: Career Awareness, Career Awareness, Cath Lab, Mayo Clinic Career Awareness, Mayo Clinic Career Awareness, Nursing, Nursing, Patient Care, Uncategorized