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Tip 51 is actually ten tips in one.  The ten tips are to help you to implement better interventions.  Number one; use the “quick-check” assessment to find problems early on.  The “quick-check” assessment focuses on those things that are most likely to change so that you can do a quick assessment between your more thorough assessments and find out if the patient’s condition is changing. 

Number two; look for red flags to recognize the problem.  Red flags are subtle signs and symptoms that alert you to the development of a complication.  Number three; use the roadmap to identify the source of the problem.  The roadmap is your problem list.  Here, we put down all the things that could possibly be wrong with the patient so that we have something to refer back to if it looks like the patient’s problem doesn’t fit what we originally thought. 

Number four; find the reference facts you need on your Palm Pilot.  Once again I’ll reiterate that using a Palm Pilot has helped many nurses to have the important reference information that they need at the patient’s bedside.  Number five; identify the most appropriate diagnostic tests to narrow down your problem list.  You go back to your roadmap where you identified the diagnostic tests that are most likely to narrow the list down and get you on the right track. 

Number six; implement interventions for the worst-case scenario first.  So based on the problem that you have identified with the roadmap that you think is most likely happening with our patient, you will ask yourself, what’s the worst thing that could happen?  This is the worst-case scenario.  Now you can focus your assessment on the signs and symptoms of the complication that is starting to occur. 

Number seven; high impact interventions should be implemented first.  That goes along with number eight.  Interventions with low impact should wait until later.  Try to organize your work based on which interventions are going to have the highest impact at this particular time. 

Number nine; assess the patient’s response to intervention.  Make sure you document that also.  Lastly, number ten, look for complications and revise the map as necessary.  If you implement these ten tips, you will implement better interventions.