4 Eyes in 4 Hours Mindful Rounding J

4 Eyes in 4 Hours • Mindful Rounding – J by your Skin Care Team: • Penny Pitford CWON and Aleatha Myers WON

4 Eyes in 4 Hours Program to assure that pressure injuries that are present upon admission are charted timely. If they are not charted timely, we are dinged for “causing” the injury.

4 Eyes in 4 Hours • Every patient upon admission and transfer patients will get a full head to toe skin assessment by the primary nurse and charted within 4 hours. • They will also get a second set of eyes (another RN) to do a full head to toes skin assessment and also chart it within the first 4 hours. • This will be monitored during chart reviews.

4 Eyes in 4 Hours • The primary nurse charts their assessment in the patient’s chart. Include all wounds and wound assessments. • The second nurse charts in the nursing narrative, either; “I have completed this patient’s head to toe skin assessment and I agree with the primary nurse’s charting” or go to the primary nurse to discuss differences in your assessments. Then before the 4 hours is up, assure that you are in agreement and primary nurse has charted accurately and then make a note stating you agree.

4 Eyes in 4 Hours • Why are we doing this 4 eyes in 4 hours program? • If a pressure injury which is present upon admission isn’t charted as such w/in the first 24 hours. Then our hospital takes very large financial hits. Numerous other hospitals have moved to this practice. Nurses state that they don’t notice an significant increase in time required to complete the task and the hospitals state that they have dropped their HAPI significantly (as much as 50%). • It is a small step to insure a large financial improvement. • Internal Medicine has volunteered to trial this program.