Reva
Klar
January 2011
Reva
Klar
,
RN, MSN, GCNS-BC
Medical-Surgical, Oncology Unit
DMC Sinai-Grace Hospital
Detroit
,
MI
United States
Reva works on the TCAB unit. This unit is involved in Transforming Care at the Bedside. This concept empowers staff to decide upon an innovation and carry it out without having to go through weeks and months of approval processes.
Family Teaching and Care
Reva is always identifying patient issues for either teaching purposes or resolution of issues. In early February, 2011, while Reva was making rounds on her unit, a patient's daughter said she thought her mother felt warm and wondered what the treatment plan was for the patient. Reva took the patient's temperature and found that the temperature was elevated. She checked the woman's lab work and found the WBC was also elevated. Reva notified the physician and asked him to come to the unit to discuss the patient's plan with the daughter. The physician did this and the daughter was relieved. A few days later when Reva was again making rounds, she noticed the patient's IV was low and the patient's daughter was again in the room. The daughter was again concerned about her mother's condition. Reva noted that the patient was in isolation for c difficile. Reva followed up with the nephrologist who reordered her IVs. The patient's daughter had gone home, so Reva called her and explained the treatment change and give her an update on her mother. It is not unusual for Reva to stay until 8 or 9 PM to address patient issues with the family.
Patient Safety:
Reva entered a patient's room because of a beeping alarm. The patient had a ventimask on but a Bipap machine was next to the bed. The patient was uncomfortable and restless. Reva placed the Bipap mask on the patient and called respiratory to verify the settings. The settings needed to be changed, as the patient was receiving too much oxygen, so respiratory came up to change the settings and the patient was much more comfortable.
Patient Advocacy:
In early February, 2011 the nursing supervisor had received call from a family member concerned about nursing care for her mother. When Reva entered room the patient was moaning and had labored breathing. The patient's son felt the patient was doing ok and wanted her transferred to a nursing home that evening. The nurse took the patient's BP and found it had had skyrocketed to 220/116. While the nurse called the physician and got an order for Vasotec, Reva stayed with the family. The patient's son stated he wanted the patient transferred to the nursing home that afternoon and wanted to make sure the transfer happened. The patient's son also stated the plan was for patient to be admitted to Hospice when she entered the nursing home even though the papers were not yet signed. The patient's BP finally came down to 106/41. The staff nurse explained to the patient's son (who was not the guardian) that an ambulance would not pick up patient in this condition (moaning and with labored breathing) as patient was unstable. It was discovered that the patient had a guardian and the patient's son and daughter were attempting to have the patient discharged from the hospital and admitted to another institution as a hospice patient without the consent or knowledge of the guardian. Reva and the nurse for the patient discussed the issue with the patient's guardian and it was decided that the patient should not be moved, but would be transferred to Season's Hospice, at Sinai Grace Hospital. This was done and the patient was made comfortable. Once this was accomplished, neither the patient's son nor daughter could be found. Reva and this nurse allowed this patient to rest comfortably for a few more days under the caring and comforting watchful eyes of the nursing staff here at Sinai Grace.
Teaching and Education
I believe Reva Klar demonstrates the highest quality nursing care demonstrated by a nurse at Sinai Grace Hospital. Reva manages educational classes for all nursing staff by providing contact hour presentations on a monthly basis. She also provides special education classes for charge nurses on an annual basis as well as an oncology nursing course each year for staff on her unit. She also provides programs for unit clerks and our patient care associates. The PCAs are offered quarterly Lunch and Learn programs that Reva coordinates and provides to both the day and night shift PCAs. There is no other person at Sinai Grace that carries the charge of educating staff to the degree that Reva does.
Family Teaching and Care
Reva is always identifying patient issues for either teaching purposes or resolution of issues. In early February, 2011, while Reva was making rounds on her unit, a patient's daughter said she thought her mother felt warm and wondered what the treatment plan was for the patient. Reva took the patient's temperature and found that the temperature was elevated. She checked the woman's lab work and found the WBC was also elevated. Reva notified the physician and asked him to come to the unit to discuss the patient's plan with the daughter. The physician did this and the daughter was relieved. A few days later when Reva was again making rounds, she noticed the patient's IV was low and the patient's daughter was again in the room. The daughter was again concerned about her mother's condition. Reva noted that the patient was in isolation for c difficile. Reva followed up with the nephrologist who reordered her IVs. The patient's daughter had gone home, so Reva called her and explained the treatment change and give her an update on her mother. It is not unusual for Reva to stay until 8 or 9 PM to address patient issues with the family.
Patient Safety:
Reva entered a patient's room because of a beeping alarm. The patient had a ventimask on but a Bipap machine was next to the bed. The patient was uncomfortable and restless. Reva placed the Bipap mask on the patient and called respiratory to verify the settings. The settings needed to be changed, as the patient was receiving too much oxygen, so respiratory came up to change the settings and the patient was much more comfortable.
Patient Advocacy:
In early February, 2011 the nursing supervisor had received call from a family member concerned about nursing care for her mother. When Reva entered room the patient was moaning and had labored breathing. The patient's son felt the patient was doing ok and wanted her transferred to a nursing home that evening. The nurse took the patient's BP and found it had had skyrocketed to 220/116. While the nurse called the physician and got an order for Vasotec, Reva stayed with the family. The patient's son stated he wanted the patient transferred to the nursing home that afternoon and wanted to make sure the transfer happened. The patient's son also stated the plan was for patient to be admitted to Hospice when she entered the nursing home even though the papers were not yet signed. The patient's BP finally came down to 106/41. The staff nurse explained to the patient's son (who was not the guardian) that an ambulance would not pick up patient in this condition (moaning and with labored breathing) as patient was unstable. It was discovered that the patient had a guardian and the patient's son and daughter were attempting to have the patient discharged from the hospital and admitted to another institution as a hospice patient without the consent or knowledge of the guardian. Reva and the nurse for the patient discussed the issue with the patient's guardian and it was decided that the patient should not be moved, but would be transferred to Season's Hospice, at Sinai Grace Hospital. This was done and the patient was made comfortable. Once this was accomplished, neither the patient's son nor daughter could be found. Reva and this nurse allowed this patient to rest comfortably for a few more days under the caring and comforting watchful eyes of the nursing staff here at Sinai Grace.
Teaching and Education
I believe Reva Klar demonstrates the highest quality nursing care demonstrated by a nurse at Sinai Grace Hospital. Reva manages educational classes for all nursing staff by providing contact hour presentations on a monthly basis. She also provides special education classes for charge nurses on an annual basis as well as an oncology nursing course each year for staff on her unit. She also provides programs for unit clerks and our patient care associates. The PCAs are offered quarterly Lunch and Learn programs that Reva coordinates and provides to both the day and night shift PCAs. There is no other person at Sinai Grace that carries the charge of educating staff to the degree that Reva does.