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
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.
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.