House Staff Manual - Winthrop University Hospital

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Intravenous fat emulsion or solutions of amino acid alone or in combination can also be ordered on thisform.The Pharmacy Parenteral Nutrition Order Form must be completed, signed and dated by the physician,and sent to the Pharmacy by 12:00 Noon on the day the solution is to be administered. Changes informulation require a new order form to be completed.4. Outpatient Prescriptions: The Pharmacy Department does not fill outpatient prescriptions fordischarged patients. All unused medication for patients going home are to be returned to thePharmacy, and new prescriptions must be written. All prescriptions for outpatients must contain thefollowing information-Full name of patient-Age of patient-Patient's address-Date prescription written-Name and strength of drug-Quantity of drug (specific as to volume, weight, or quantity of dosage units)-Directions for use-Signature and identification number. For all controlled drugs, use DEA number of institution andphysician's number assigned by institution-Signature, identification number and prescriber's name, mechanically printedTELEPHONE ORDERSTelephone orders should be used sparingly, and when used, must be done using the Read Back Policy andsigned by House Staff within 24 hours. If this is not done, the nurse will try to contact the individualresponsible for the order and if the individual cannot be contacted, the senior resident on duty for theservice will be asked to evaluate, sign, or discontinue the drug therapy. The senior resident will also beresponsible for reporting the event to the Director of Service on the next regular duty day.AUTOMATIC STOP ORDERSThe following medication stop orders are in effect:1. Controlled Drugs: Schedule II - requires renewal every 48 hours and Schedule III, IV, V - requiresrenewal every 72 hours.2. Anticoagulants: require renewal every 24 hours.3. Chemotherapeutic agents: require renewal every 24 hours.4. Antibiotics: require renewal every 5 days.5. Steroids and other hormones: require renewal every 7 days.6. Standing orders: automatically canceled when a patient undergoes surgery.BEDSIDE MEDICATIONSThe policy for the use of bedside medications at Winthrop-University Hospital is as follows:1. In general, patients should not take their own medications. If a physician requests that a specificpatient take his or her own medications, the following procedure must be carried out:The physician is to indicate on the chart the name of the medication, strength, and directions foruse along with the statement -- "Patient may take own meds at bedside."Rev. 1/08
The medication must be sent to the Winthrop-University Hospital Pharmacy for verification priorto the patient being able to self-administer the medication.The nurse is responsible for charting the patient’s own medications.2. The following types of medications may be left at the patient's bedside:-Ophthalmic preparations-Antacids-Nitroglycerin tablets-Birth control pills-Metered dose inhalers for asthma or COPD3. Nursing collects and stores until discharge all patient medications not used during their stay.93. PSYCHIATRIC LIAISONWinthrop’s Department of Psychiatry provides psychiatric services for inpatients and EmergencyDepartment patients. Under the direction of the Chairman of Psychiatry, the on-call psychiatrists and apsychiatric liaison provide case consultations, case management, discharge facilitation, staff education andsupport groups. Members can be contacted at ext. 2691 weekdays during daytime hours, and the on-callpsychiatrists can be reached at any time through the telephone operator.94. PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERSWinthrop-University Hospital supports the utilization of Physician Assistants (PA) and Nurse Practitioners(NP) to provide medical care to patients in our institution, i.e. admitted patients, patients in the ED andoutpatient practices. PAs and NPs are licensed to practice medicine and are credentialed members of theMedical Staff who are committed to practicing as members of attending physician-directed teams. Someservices are exclusively utilize PAs and NPs, where others have PAs and NPs and residents workingtogether to provide care. The presence of PAs and NPs enables the hospital to meet its mission, maintaincompliance with ACGME standards and enhance a resident’s academic environment. They are involved atmany levels within the institution such as Administration, Medical Education, Quality Improvement andCommunity Outreach. PAs and NPs are respected members of the Medical Staff, and contribute positivelyto the medical care provided to our patients in the hospital and in the community.95. PULMONARY FUNCTION LABORATORYPulmonary Function Tests are performed between the hours of 8 A.M. to 4 P.M. Monday through Friday.Requests called in during this time will be placed in a queue and will be completed as quickly as possible.Requests may also be called in at other times at which point please leave a message on the Department'svoice mail to include the patient's name, room number, ID or MR #, diagnosis and the tests to beperformed. The Lab is located on the Lower Level - Potter Pavilion, ext. 2286. Tests include:1. Full Pulmonary Function Tests with or without Bronchodilator: Includes Flow Volume Loop, LungVolumes, Diffusion Capacity, Maximum Voluntary Ventilation. Post Bronchodilator Studies repeatFlow Volume Loop and Maximum Voluntary Ventilation.2. Bedside Flow Volume Loop: utilized for pre-operative clearance and patients unable to be brought tothe Laboratory for full testing.3. Bronchial Provocation Challenge: utilized to confirm diagnosis of hypersensitive airways.96. RADIOLOGYRADIOLOGY HOURSRev. 1/08
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OFFICE OF ACADEMIC AFFAIRS222 Stati
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Winthrop-University HospitalHouse S
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WINTHROP-UNIVERSITY HOSPITALHOUSE S
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72) Institutional Review Board73) O
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HOUSE STAFF BENEFITSAND SERVICES1.
Page 11 and 12: The New York State Department of He
Page 13 and 14: valuable information and resources,
Page 16: 25. STUDENT LOAN DEFERMENTSResident
Page 19 and 20: the program director. Residents sho
Page 21 and 22: 2. Residents shall not be scheduled
Page 23 and 24: PROCEDUREImmediate Action:1. Clinic
Page 25: All House Staff are evaluated in wr
Page 28 and 29: appropriate in every circumstance.
Page 32 and 33: Delegating professional responsibil
Page 36 and 37: TREATMENT OF EMERGENCY DEPARTMENT P
Page 38 and 39: The commencement of brain death cri
Page 40 and 41: Diseases in all capital letters req
Page 42 and 43: Either the patient or person consen
Page 44 and 45: If a patient has a living will, it
Page 46 and 47: should be referred to Risk Manageme
Page 48 and 49: Refusal of treatment on behalf of a
Page 50 and 51: Sentinel events are considered unex
Page 52 and 53: Discharge plans are made based on p
Page 54 and 55: 2. Telephone orders are limited to
Page 56 and 57: 8. The Heath Information Management
Page 58 and 59: Manual kept at each nursing station
Page 60 and 61: The Microbiology Lab on the second
Page 64 and 65: 1. Diagnostic ProceduresEmergency R
Page 66 and 67: using a bar code format and your pe
Page 68 and 69: 100. PATIENT RELATIONSStaff in the
Page 70 and 71: patient has the right to timely not
Page 72 and 73: infections in body and other body f
Page 74 and 75: Winthrop-University HospitalFrequen
Page 76 and 77: Pulmonary (Dir.) ..................
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House Staff Manual - Winthrop University Hospital

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