Hospitals of La Mirada, San Gabriel, Santa Ana

Charge Nurse Checklist

PATIENT SPECIFIC
All patient rooms have appropriate transmission based isolation sign Hand washing and PPE observations completed All patients have legible ID band and allergy band All Central Line dressings have date/time and initials of RN within 7days All Foley catheters have date of insertion noted on bag within 30 days. All feeding bags have date/time and initial within 24 hours All TPN/PPN and tubing has filter and date/initial within 24 hours All IV bags/tubing has time/date and initial per policy Patient rounding/repositioning documentation completed as ordered. First dose medication administration reactions documented in Protouch Daily weight completed as appropriate (i.e., TPN, dialysis patients)

ENVIRONMENT OF CARE
Crash carts checked o Station 1 o Station 2 o Station 4 o ICU Glucometer test strips and reagents are label with the date on the bottle. Reagents dated within 3 months and test strips dated within 4 months All equipment is plugged into the appropriate plugs o Ventilators into red plugs o IV pumps, air mattress, feeding pumps, and beds plugged into white plugs.

Hospitals of La Mirada, San Gabriel, Santa Ana

ADMISSIONS
Admission orders complete. Including Admit to Kindred La Mirada Medication Reconciliation completed and faxed to pharmacy DVT Assessment complete with appropriate orders Fall Risk Assessment Complete Skin Assessment/Wound Assessment in correct pathway with photos taken Patient/Family Education materials given and documented in Protouch Individualized care plan completed o Restraints o Isolation o Fall Risk o Anticoagulation

DISCHARGES
Discharge order in the chart Medication Reconciliation for discharge Discharge Pathway complete o Nursing o RT o Rehab o Social Work/Case Management Prescriptions attached Family notified of discharge/transfer

PERFORMANCE IMPROVEMENT/DOCUMENTATION
Restraints audit complete (orders within timeframe, documentation complete) Admission audits complete Blood administration audits complete Anticoagulation audits complete Critical Lab Value documented in Protouch and log completed

Hospitals of La Mirada, San Gabriel, Santa Ana

Critical Lab Nurse audits collected and forwarded to education department Check Telcor for exceptions. Report to clinical analyst if unable to resolve