staffing frans

JMJ

Marist Brothers

Notre Dame of Dadiangas University

Marist Avenue General Santos City

College of Nursing

TEAM NURSING

STAFFING

Mindanao Medical Center

(Station 2)

Shift: 7:00 am – 3:00 pm

Submitted to:

Esperanza Ala-an, RN

Submitted by:

Francis Kaye Javier, SN

Group 2 – Team B

Table of Contents

A. Nightingale’s Pledge

B. Nurse’s Prayer

C. Introduction

D. Objectives

E. Plan of Activities

F. Individual Roles

Team Leader

Charge Nurse

Medication Nurse

Bedside Nurse

G. General Paraphernalia Description

H. Organizational Structure

I. Endorsement Strategy

J. Schedule of Breaks

Snack Time

Lunch Time

K. Attendance Record

L. Paraphernalia Record

M. Ward Uniform

N. TPR Sheet

O. Book Assignment

P. Patient’s List

Q. Anecdotal List

R. Summary of Extension Duties

The Nightingale’s Pledge

I solemnly pledge myself

before God and presence of this assembly

to pass my life in purity and to practice

my profession faithfully.

I will abstain from whatever is deleterious

and mischievous and will not take or knowingly

administer any harmful drug.

I will do all in my power

to maintain and elevate the standard

of my profession and will hold in

confidence all personal matters committed to

my keeping and family affairs coming to my

knowledge in the practice of my calling.

With loyalty will I endeavor to work

closely with the health team, and devote myself

to the welfare of those committed to my care.

So help me God, and Notre Dame.

Nurses’ Prayer

Oh my God,

Give to my heart compassion and understanding

to my hands skill and tenderness,

a gentle touch with patience and love.

To my ears the ability to listen,

to my lips words of comfort.

When I falter and tire

give me courage and strength,

when I weaken because I’m human,

inspire me on to greater length.

In humility Lord, I labor long hours,

I may sometimes fret; My mission is mercy.

Abide with me, that I may never forget. Lord, give me

the intelligence, intuition, and knowledge to assess.

The reason, rationality, and understanding so I may

plan. Energy, agility, and tenderness during

implementation. The wisdom, perception and fairness to

evaluate. Most of all Lord, give me patience,

compassion and kindness for all people,

to those I am called to serve.

Amen.

Introduction

Team Nursing is the delivery of individualized nursing

care to clients by a team led by a professional nurse. A

nursing team consists of registered nurses, licensed practical

nurses and unlicensed assistive personnel. This team is

responsible for providing coordinated nursing care to a group

of clients.

The registered nurse retains responsibility and

authority for client care but delegates appropriate tasks to

the other team members. Proponents of this model believe

the team approach increases the efficiency of the registered

nurse. Opponents state that inpatients’ high acuity of illness

leaves little to be delegated. (Kozier 2004)

“Care through others” became the hallmark of team

nursing. It has been developed in an effort to decrease the

problems associated with the functional organization of

patient care majority of people felt that despite a continued

shortage of professional nursing staff, a patient care system

has to be developed that reduce the fragmented care that

accompanied functional nursing.

Team nursing is based on philosophy in which groups

of professional and non-professional personnel work together

to identify, plan, implement and evaluate comprehensive

client-centered care. The key concept is a group that work’s

together toward common goal, providing qualitative

comprehensive nursing care (Kron 1978). It was designed to

accommodate several categories of personnel in meeting the

comprehensive nursing needs of a group of clients (Donavan

1975).

The main objective of team nursing in this clinical

exposure is to give the best possible quality of patient care

by utilizing the abilities of every member of the staff to the

fullest extent and by providing close supervision both of

patient care and of the individual who give it. It aims to

develop the essential skills, knowledge and the right attitude

that the student nurse needed to become a competent and

efficient health care professional in the future.

Objectives

General:

Give the best quality, efficient and effective nursing care to the clients of Mindanao Medical Center by being competent on all aspect of human health through the collaborative teamwork of Group 3 Team A.

Specific:

Execute the diverse functions and responsibilities in team nursing;

Develop skills, knowledge and attitude of good human relationship with the health teamthrough appropriate coordination and observationof ethics and institutional policies;

Establish trust and rapport to the patients and staffand other hospital personnel;

Identify and be able to do the different responsibilitiesof each team member and help them in providing careto the patient;

Provide holistic and individualized care to thepatients;

Impart health teachings to all patients related totheir respective cases;

Perform nursing procedures appropriately and efficiently;

Build up effective time management; Develop camaraderie and harmonious relationship within the team.

Plan of Activities

Time Activities Rationale5:30 am

Arrival at the area

Morning Prayer

Student nurses should be earlier than the expected time to have a final preparation for the actual duty. This is when pre-conferences, checking of attendance, uniforms and paraphernalia are done. The team leader should arrive first to check if there are new patients on the present shift to be included in the assigning of patients to the team.

To ask the guidance of the Almighty God for the entire shift. His presence is needed for the team to perform better and to avoid committing errors that may harm the patient’s health status.

6:00 am

Pre-conference

Checking of attendance of the team members

Pre-conferences are done to organize the team and be ready for the incoming shift. Important details and reminders are given to each member of the team to facilitate unity and proper coordination of significant information.

To check the presence of each member of the team to make sure that the works are properly disseminated. Absence of any member would require the transfer of authority and work to render quality nursing care.

Establishing goals/objectives of the team

Charge nurse, team leader, bedside nurse and the medication nurse will receive endorsement from the staff on duty

To be guided by the objectives of the entire shift. Each member of the team must be properly oriented of the objectives.

For the continuity of care for our patients, each team member should be aware of the latest endorsements from the last shift. This will provide relevant information for the care of the patient regarding his/her condition. This may include diet, IV infusions, latest doctor’s order, follow ups and interventions given.

7:00 am

Student nurses rounds on their respective assignments

Introduction to the assigned patient and establish rapport

To have a partial introduction of our patients regarding our purposes and responsibilities as a health care provider. It will also allow us to recheck the endorsement being given.

To establish trust and rapport with the patients, to minimize their anxiety so this will give way in rendering care. Introducing self properly to the patients will give them security regarding their concerns.

7:10 am

7:30 am

Vital signs taking

Checking and regulating of the patient’s IVF

To establish baseline data and note any abnormalities, deviations from normal, so as to give appropriate care and report accurately to the team leader so that it will be forwarded immediately to the clinical instructor and proper intervention will be given to the patient.

To validate if the proper order and regulation of the IVF is strictly followed to ensure that the care is rendered accurately.

7:45 am

Beside nurse will conduct their morning care and beside care for the patients

Bed making

To make the patients feel fresh and comfortable. This will boost their self-esteem that will somehow aid in the progress of patient’s health status.

The bed is one of the most important facilities in making the patient comfortable since it is where the patient rest during the course of hospitalization. A clean, wrinkle-free bed that remains intact when a patient moves does a great deal for the patient’s physical and psychological comfort and it decreases the spread of microorganisms.

Medication nurse will clean the medication area and prepare the medicines that will be given at 8am. The medication nurse will recite to the clinical instructor the drug study of the medications to be supported by the team leader before administration

Appropriate drug studies should be made regarding the drug so that the student nurse will know the drug and why it is given to the patient.

It is also the team leader’s responsibility to double check the medication to be given and the administration of the medication. She must also support the medication nurse whenever he’s in doubt, cannot answer and/or perform the task.

8:00 am

Medication nurse administer medications together with the team leader and the clinical instructor, observing the 12 R’s of drug administration.

So as to double check the administration of medication and observe the 12 R’s of drug administration.

9:00 am

Providing health teachings to the patients and significant others that will aid for their recovery. At the same time, gathering information from the patient and significant others for the baseline date for the NCP

To expand patient’s awareness of their health condition and to be informed of the correct and proper interventions that must be performed to maintain wellness during and even after the hospitalization.

Relevant data of the patient and significant others will aid in identifying nursing problems and provide interventions to be rendered as health promotion.

9:15 am

9:30 am

9:45 am

10:00 am

Snack Break (Team Leader and Bedside Nurse #1)

Snack Break (Charge Nurse and Bedside Nurse #2)

Snack Break (Medication Nurse and Bedside Nurse #3)

Preparing the charts for the round of the attending physicians

For easy access and orderliness of the patient’s chart

10:30 am

Checking of sample charting and nurse’s notes

Carrying out

of the doctor’s order

Endorsement of new orders by the charge nurse to the medication nurse, and bedside nurses

The team leader must check the sample nurses notes of the bedside nurses to see if the interventions are properly done and to correct any lapses before it will be checked by the clinical instructor herself.

Proper carrying out of the doctor’s order by the charge nurse is vital for the continuity of the patient’s care.

So that the other members of the team would be aware of the latest orders from the doctor and carrying-out orders.

10:45 am

11:00 am

11:30 am

12:00 nn

Preparation of medication due at 12nn by the medication nurse

Lunch Break (Team Leader and Bedside Nurse #1)

Lunch Break (Charge Nurse and Bedside Nurse #2)

Lunch Break (Medication Nurse and Bedside Nurse #3)

Preparing the medications ahead of time lessens possibility of delays and errors in the preparation and administration of medication.

12:00 nn

12:45 pm

Vital signs taking

Administration of 12nn medications by the medication nurse

Checking of the sample nurse’s notes

To establish baseline data and to note any abnormalities, deviations from normal, so as to give appropriately care and report accurately to the team leader and forwarded to the clinical instructor.

Administration of drugs on time is necessary for the progress of patient’s health status.

Final checking of the nurse’s notes is necessary to make sure that the entries on the patient’s chart are error free.

1:30 pm

2:00 pm

2:30 pm

Final charting, graphing of the vital signs, filling up the I & O sheet, IVF checking, and doing bedside care for the patients.

All charts are closed

After care of the station

The data as well as the interventions done must be recorded. The patient’s official record is used by all members of health care team to communicate the patient’s progress and the current treatment.

By this time, all charts must be closed so that the team will be able to finish on time. The charts are also needed for the endorsement of the incoming shift so it must be made available to the nurses on duty.

As part of our duty, we should be responsible in maintaining our working area clean to prevent the spread of microorganisms.

3:00 pm

Endorsement

Post-conference

Sharing of learnings and insights and clarification of concerns with the clinical instructor.

So that the next shift will be aware of the status of the patients, latest orders given and procedures to be done. To provide continuity of care to the patients.

To evaluate the activities done throughout the duty. To strengthen and commend the strong points and improve the weak points of the team.

Preparation of things used during the duty as well as doing after acre to one’s self.

Closing Prayer

Leaving the hospital area

Thanking God for his everlasting support and guidance throughout the day.

This marks the end of duty.

Guidelines

1. Staffing requirements should be submitted 2 days before the

actual exposure.

2. Medication nurses should do the drug study before the actual

exposure. No drug study, no medication administration.

3. Charge nurse should gather the information about the patient

before the actual exposure.

4. In the absence of the charge nurse, the team leader provides

coverage especially during the doctor’s rounds.

5. Breaks should strictly observe the time allotment and should

be reported to the clinical instructor.

6. Referrals should strictly observe proper channeling.

7. Proper endorsement should be observed during breaks.

8. Courtesy should be observed at all times.

9. Though creativity is encouraged in every

requirements/activity, all efforts should be exerted to make it

as simple and practical as possible, and without sacrificing the

quality of its contents.

10. Team leaders should conduct pre and post conference.

11. Each team should prepare separate logbooks for the charge

nurse and the medication nurse.

INDIVIDUAL ROLES AND RESPONSIBILITIES

TEAM LEADER

Checks the attendance, paraphernalia and uniforms of the team members.

Makes the plan of activities, special tasks and schedules lunch and break time of members.

Checks the sample charting of the bedside nurse. Follows-up the activities of the team members,

seeing to it that all actions are coordinated to attain objectives in utmost synergy.

Goes with the doctor’s rounds together with the charge nurse.

Conducts pre and post conferences. Informs the clinical instructor about any clinical

procedures done and/ or to be done to the patients.

Ensures harmonious relationship of the team and to the hospital personnel.

Evaluates performance of the team members. Gives supplemental care in the absence of one of

the members.

Carries responsibility for any untoward incidents made by the team members.

Checks the drug and know everything about the patient.

Helps any team member who is not through with their tasks.

Acts as substitute for any absences or tardiness that will be made by any members of the team.

Coordinates with staff activities.

Assists the charge nurse in carrying out doctor’s orders.

Evaluate the team through a post conference. Does the final rounds with the charge nurse.

CHARGE NURSE

Knows the members assigned to specific patients in the team.

Acts as the team leader in cases where the team leader is absent.

Receives and does the endorsement from outgoing and incoming shifts.

Makes the patient’s list and vital signs sheet.

Makes ward class and journal reading related to the selected topic.

Goes with the doctor’s and nurse’s rounds. Receives new admission, endorses any special or

new orders or procedures to the bedside nurses and follows-up requisitions.

Informs the medication nurse in any changes in drug order.

Maintains harmonious relationship with the team members and the hospital personnel.

Informs the bedside nurse for the patient’s vital signs, I and O monitoring and related special orders.

Gives the list of IVF follow ups of every patient to the bedside nurses.

Informs the team leader for any procedures that will be done to the patient.

Maintains cleanliness and orderliness of the nurse’s station.

Receives the endorsement of the patient’s status from the bedside nurses every now and then.

MEDICATION NURSE

Makes the drug study. Knows the drug of the patient ahead of time. Prepare and administer the medications while

observing the 12 R’s Prepares the meds ahead of time but with special

precaution to drugs that are to be reconstituted. Reports any error in drug administration to the

team leader. Makes the prescription for unavailable

medications. Records all given medication.

Administers medication in front of the team leader and the clinical instructor.

Coordinates with the team leader before and after giving medications.

Coordinates with the charge nurse in any changes or new drug orders.

Explains to the patient the administered drug. Checks the condition of the patient before and

after administering the drug.

BEDSIDE NURSE

Knows the list, kinds of cases, room number of the patient ahead of time.

Receives endorsement and goes with the nurse’s rounds.

Monitors the patient. Educates the patient and significant others about

the disease process. Endorses the latest vital signs of the patient. Report any unusual changes in the patient’s vital

signs. Maintains cleanliness of the patient’s units. Knows the IVF level of the patient and regulate it

properly. Does the morning care of the patient.

Follows up all the IVF consumed by the patient. Provides immediate care needed by the patient. Do the documentation of the patient’s care. Reports any unusualities to the patient’s condition

to the charge nurse or head nurse and notify the clinical instructor.

Performs procedures with the supervision of the team leader and clinical instructor.

Prepares IVF tags. Prepares patient’s bedside label.

GENERAL PARAPHERNALIA

Ballpen Red, Blue or Black – this item is essential in documentation. When you are documenting, it is necessary to use permanent marker such as ballpen, considering the legality of patient’s chart. Its color signifies something and it depends on the institution what color they will use.

Bandage Scissors - for cutting bandages, tapes, etc.

Blood Pressure Apparatus - use to monitor one of the five vital signs of a person, the blood pressure.

Jot down Pocket Notebook - use by nursing students in doing initial documentation.

Medicine Glass - it is intended for measuring liquid form drugs.

Nail Cutter - use for trimming uncut nails of patients in order to prevent infection and promote self-wellness of patients.

Pencil with Eraser - for documentation purposes

Penlight - use in checking orifices of patients (e.g. eyes, nose, mouth).

Pentel Pen - for Intravenous line marking.

Small Medicine Tray - it helps the medication nurse in providing an organized administration of medications to patients.

Six-Inch Ruler - use in graphing vital signs of patients.

Tape Measure- use to measure the anthropometric measurement of patients.

Maria Magdalene de Pedro, SNCharge Nurse

Evony Grace Delgado, SNMedication Nurse

Thermometer (oral and rectal) - to get the actual body temperature of patients.

Thread and Needle - to fix tangles in the uniform.

RLE Record Book- serves as a guide to a student nurse.

Mask and gloves -serves as a protection of nursing students against communicable diseases, etc.

ORGANIZATIONAL STRUCTURE

ENDORSEMENT STRATEGY

During Break times and Lunch time:

Team Leader (Francis Kaye Javier) will endorse his tasks to the Charge Nurse (Maria Magdalene de Pedro).

Charge Nurse (Maria Magdalene de Pedro) will endorse her tasks to the Team Leader (Francis Kaye Javier).

Medication Nurse (Evony Grace Delgado) will endorse her tasks to Team Leader (Francis Kaye Javier).

Bedside Nurse 1 (Cynderlyn Gonzaga) will endorse her tasks to the Bedside Nurse 2 (Mary Rose Josol).

Ms. Esperanza Ala-an, RNClinical Instructor

Mary Rose Josol, SNBedside Nurse 2

Cynderlyn Gonzaga, SNBedside Nurse 1

Gerald Larida, SNBedside Nurse 3

Bedside Nurse 2 (Mary Rose Josol) will endorse her tasks to the Bedside Nurse 3 (Gerald Larida).

Bedside Nurse 3 (Gerald Larida) will endorse his tasks to the Bedside Nurse 1 (Cynderlyn Gonzaga).

SCHEDULE OF BREAKS

Student nurse Snack time Lunch time


(Team Leader)

9:15-9:30 am 11:00-11:30 am

Maria Magdalene de Pedro, SN

(Charge Nurse)

9:30-9:45 am 11:30-12:00 pm

Evony Grace Delgado, SN

(Medication Nurse)

9:45-10:00 am 12:30-1:00 pm

Cynderlyn Gonzaga, SN

(Bedside Nurse #1)

9:15-9:30 am 11:00-11:30 am

Mary Rose Josol, SN(Bedside Nurse #2)

9:30-9:45 am 11:30-12:00 pm

Gerald Larida, SN(Bedside Nurse #3)

9:45-10:00 am 12:00-12:30 pm

Attendance Record

Area: Mindanao Medical Center

Date of duty: July 29, 2010 Shift: 7am- 3pm

Name of students

Time in

Signature Time out

Signature


Maria Magdalene de

Pedro, SN



Mary Rose Josol, SN

Gerald Larida, SN


Name of students

Time in

Signature Time out

Signature


Maria Magdalene de

Pedro, SN



Mary Rose Josol, SN

Gerald Larida, SN


Name of students

Time in

Signature Time out

Signature


Maria Magdalene de

Pedro, SN



Mary Rose Josol, SN

Gerald Larida, SN

Date of duty: August 5, 2010 Shift: 7am- 3pm

Name of students

Time in

Signature Time out

Signature


Maria Magdalene de

Pedro, SN



Mary Rose Josol, SN

Gerald Larida, SN


Name of students

Time in

Signature Time out

Signature


Maria Magdalene de

Pedro, SN



Mary Rose Josol, SN

Gerald Larida, SN


Name of students

Time in

Signature Time out

Signature


Maria Magdalene de

Pedro, SN



Mary Rose Josol, SN

Gerald Larida, SN

Checking of General Paraphernalia

Paraphernalia

Francis Kaye Javier, SN Team Leader

7/29 7/30 7/31 8/5 8/6 8/7Alcohol

Ballpen:

Black Blue Red Bandage scissor BP apparatus Cotton balls Nail Cutter Jot down notebook

Mask and gloves

Medicine glass Pencil with eraser

Penlight Pentel pen RLE record book

Paraphernalia

Maria Magdalene de Pedro, SN Charge Nurse

7/29 7/30 7/31 8/5 8/6 8/7Alcohol

Ballpen:


Mask and gloves Medicine glass Pencil with eraser

Penlight

Pentel pen RLE record book

Paraphernalia

Evony Grace Delgado, SN Medication Nurse

7/29 7/30 7/31 8/5 8/6 8/7Alcohol

Ballpen:

Black Blue Red Bandage scissor BP apparatus Cotton balls Nail Cutter RLE record book Jot down notebook

Mask and gloves Medicine glass


Paraphernalia

Cynderlyn Gonzaga, SN Bedside Nurse #1

7/29 7/30 7/31 8/5 8/6 8/7Alcohol

Ballpen:


Mask and gloves Medicine glass

Pencil with eraser


Paraphernalia

Mary Rose Josol, SN Bedside Nurse #2

7/29 7/30 7/31 8/5 8/6 8/7Alcohol

Ballpen:


Mask and gloves



Paraphernalia

Gerald Larida, SN

Bedside Nurse #3

7/1 7/2 7/3 7/8 7/9 7/10Alcohol

Ballpen:


Mask and gloves



Ward Uniform Checklist


Team Leader

7/29 7/30 7/31 8/5 8/6 8/7

Caduceus Pin (Male)

Name Plate

Cap/ Haircut

Fingernail

Shoes

Smock Gown

Undergarments

Ward Uniform

Wrist Watch


Charge Nurse

7/29 7/30 7/31 8/5 8/6 8/7

Caduceus Pin (Male)

Name Plate

Cap/ Haircut

Fingernail

Shoes

Smock Gown

Undergarments

Ward Uniform

Wrist Watch


Medication Nurse

7/29 7/30 7/31 8/5 8/6 8/7

Caduceus Pin (Male)

Name Plate

Cap/ Haircut

Cynderlyn Gonzaga , SN

Bedside Nurse # 1

7/29 7/30 7/31 8/5 8/6 8/7

Caduceus Pin (Male)

Name Plate

Cap/ Haircut

Fingernail

Shoes

Smock Gown

Undergarments

Ward Uniform

Wrist Watch

Fingernail

Shoes

Smock Gown

Undergarments

Ward Uniform

Wrist Watch

Mary Rose Josol, SN

Bedside Nurse # 2

7/29 7/30 7/31 8/5 8/6 8/7

Caduceus Pin (Male)

Name Plate

Cap/ Haircut

Fingernail

Shoes

Smock Gown

Undergarment

s

Ward Uniform

Wrist Watch

Gerald Larida, SN

Bedside Nurse # 3

7/29 7/30 7/31 8/5 8/6 8/7

Caduceus Pin (Male)

Name Plate

Cap/ Haircut

Fingernail

Shoes

Smock Gown

Undergarments

Ward Uniform

Wrist Watch

Vital Signs Sheet

Day 1 (July 29, 2010)

RM #

Patient’s Name 8 a.m. 12 p.m.

T P R BP T P R BP U S

Day 2 (July 30, 2010)

RM #



Day 3 (July 31, 2010)

RM #



Day 4 (August 5, 2010)

RM #




RM #




RM #



Book Assignment

Patients List (Day 1 July 29, 2010)

Date

Room #

Pt’s Name

Age/ Sex

Chief Complaint

Admitting Diagnosis

Physician

NAME Book/s


Physical Assessment Nursing Care Plan


Drug Handbook Pharmacology


Drug Handbook Maternal and Child 2


Diagnostic Test Pathophysiology

book NANDA Pocket Guide

Mary Rose Josol, SN Medical Surgical 1 Maternal and Child 1 NANDA Pocket Guide

Gerald Larida, SN Medical Surgical 1 MIMS NANDA Pocket Guide


Date

Room #

Pt’s Name

Age/ Sex

Chief Complaint

Admitting Diagnosi

Physician

s


Date

Room #

Pt’s Name

Age/ Sex

Chief Complai

Admitting

Physicia

nt Diagnosis

n

Patients List (Day 4 August 5, 2010)

Dat Roo Pt’s Age/ Chief Admittin Physicia

e m # Name Sex Complaint

g Diagnosis

n


Date

Room #

Pt’s Name

Age/ Sex

Chief Complaint

Admitting Diagnosis

Physician


Date

Room #

Pt’s Name

Age/ Sex

Chief Complaint

Admitting Diagnosis

Physician

Anecdotal Report

Week 1

Student Rating Remarks


Maria Magdalene de

Pedro, SN



Mary Rose Josol, SN

Gerald Larida, SN

Week 2

Student Rating Remarks


Maria Magdalene de

Pedro, SN



Mary Rose Josol, SN

Gerald Larida, SN

Summary of Extension Duties

Student Total # of extension duty

Remarks

hoursFrancis Kaye

Javier, SN

Maria Magdalene de

Pedro, SN



Mary Rose Josol, SN

Gerald Larida, SN

staffing frans

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