Controlled Substance ESCAPE ROOM

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Vanderbilt controlled Substances

Controlled Substances Escape Room

Mission 01

THIS IS YOUR STORY:You are a new nurse to Vanderbilt University Medical Center who aspires to become a strong patient advocate for pain management. To achieve this, you must infiltrate the underworld and solve the 4 missions that appear on the map. Make sure you have your notebook handy to write down the clues you get. If you collect all the clues, you will get the combination that opens the briefcase with your reward, good luck!

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Open the card

A provider has ordered IV narcotic pain medicine for your patient. How many nurses does it take to initiate the administration of IV narcotics?

Riddle

Continue

Drag the letters in this space and form the answer to the above riddle.Then, write down the numbers that go with each letter in order to get your secret number.

Form the code

Return to question

Congratulations!you have successfully completed mission 1. don't lose the code you've just discovered!

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Controlled Substances Escape Room

Mission 02

"Without a password you can't get in."

Enter the password

Read the conversations carefully to obtain information that will help you answer the questions in mission 3 correctly.

Continue

Click on each quote to get the secret letters to spell the medication password

(Dialogue 06) One good thing about music, when it hits you, you feel no pain - Bob Marley

(Dialogue 05) The pain will leave once it has finished teaching you...

(Dialogue 04) The way I see it, if you want the rainbow, you gotta put up with the rain - Dolly Parton

(Dialogue 03) What hurts us is what heals us - Paulo Coelho

(Dialogue 01) Pain is inevitable, suffering is optional - Buddhist proverb

(Dialogue 02) There is no one who loves pain itself, who seeks after it and wants to have it, simply because it is pain...

Click on each quote to find the secret information

• Pain managment is a multidisciplinary effort between providers, nurses, and specialized consultants as needed.

• Patients are to be medicated per orders, on schedule and PRN, within parameters that include pain scale, VS, and RASS.

• Pain is to be assessed on admission, with any change in care or patient behavior, and after PRN pain dose is given.

• If medicating with a medication less than the recommended dose, per the ordered pain scale, the nurse must document 'at patient's request' in the MAR at time of administration.

• Provider is to be notified if the patient is over medicated or not receiving pain relief from the pain medications.

A patient may receive pain medication on a schedule and PRN as long as a provider's order is in place. Patients may only take their own medication once pharmacy has recieved and documented the medication correctly.

(Dialogue 02) There is no one who loves pain itself, who seeks after it and wants to have it, simply because it is pain...

Controlled Substances Escape Room

• Physical or Occupational Therapy - needs an order

• Heat - needs an order

• Ice - needs an order

• relaxation techniques

• music

• decreased stimulation - lower blinds, decrease noise

• aromatherapy

• meditation

Alternative, non-pharmacological methods for pain management that should be attempted and documented, if applicable for the patient are not limited to the list below.

(Dialogue 05) The pain will leave once it has finished teaching you...

Controlled Substances Escape Room

• Continuous Controlled Substance Infusion and Patient-Controlled Analgesia (PCA)_ Administration and Management (SOP) (34248_4); paragraph III.E.

• Controlled Substance Administration and Accountability (SOP) (30060_11); Paragraph H.2

• Patients may receive pre-procedure medication as ordered. A nurse may need to travel with the patient for safety.

• A patient receiving patient controlled analgesia (PCA) therapy, may be transported off the unit if the Policy is followed.

• With every new infusion, new container (e.g., bag, syringe), and at handover, two qualified licensed staff members perform an independent double check of the following against the patient care order and document dual sign-off.

Patients will continue to receive pain management even when going for tests or changing units/level of care.

(Dialogue 01) Pain is inevitable, suffering is optional - Buddhist proverb

Controlled Substances Escape Room

• Right patient

• Right medication

• Right dose

• Right route

• Right time to adhere to the prescribed frequency and time of administration

• Right infusion set-up (primary vs. secondary)

• Right concentration and volume

• Right infusion rate

• Right pump settings

• Right line attachment and clamps open.

There are 5 main rights of pain medication administration and 5 more when it's an IV administered pain medication

(Dialogue 04) The way I see it, if you want the rainbow, you gotta put up with the rain - Dolly Parton

Controlled Substances Escape Room

• Pain management education
• Document on admission who and how you educate about pain management.
• Educate the patient and any family or caregivers the patient needs.

• Pain reassessment must be documented and addressed after all PRN doses and any changes in condition.

• When a patient requests and pain medicine that is not congruent with the pain scale PRN pain medication order, it must be documented in the MAR as 'patient request/preference'

The documentation of pain management is as important as the pain management itself. It provides the necessary resources to assess and measure its effectiveness.

(Dialogue 06) One good thing about music, when it hits you, you feel no pain - Bob Marley

Controlled Substances Escape Room

• Policy: Pain Management - click me

a. The following may be considered:i. A medication ordered for less severe pain; or ii. A less intrusive ordered route of administration. b. The patient’s preference is documented in the medication administration record (MAR). c. Staff consider consulting with patient’s ordering practitioner.

When the patient or patient delegate describes a preference for a medication not congruent with pain scale PRN pain medication order:

(Dialogue 03) What hurts us is what heals us - Paulo Coelho

Controlled Substances Escape Room

Congratulations!you have successfully completed mission 2. YOU'RE VERY CLOSE TO OPENING THE CASE!

Controlled Substances Escape Room

map/misSiONS

Mission 03

Enter the secret narcotic word found in the information pages.

Enter the password

Answer the question

Second question

Pain is inevitable, suffering is optional - Buddhist proverbAll infusing pain medicine may be transported with the patient when going for testing or changing units.

C Yes, a license authorized staff must accompany the transport.

B Yes, disconnect and give it to the transported to bring it to the next area with the patient

A No, the pain medicine belongs to the floor and cannot be shared with other areas

New number obtained

Continue

Congratulations! You've got your second secret number to open the briefcase.

Correct

"I've found you out..."

again?

you have successfully completed mission 3. and you haven't been discovered yet! maybe you'll make it after all...

Controlled Substances Escape Room

map/miSsions

Mission 04

Reasses and document effectiveness of all PRN medication given

Document in the MAR the medication given by scanning the patient and the medication

Retrieve the prescribed medication from the ADS and bring to the patient's room

Assess & document pain with vital signs at a minimum

Remember the order you form for later.

Place the process for documenting pain management in the correct order

Order

abcd

bacd

acbd

What secret code have you obtained?

Choose

Not the correct orderTry again!

again!

Remember the order you form for later.

D.Stop the infusion and report to the provider over sedation immediately

Place pain management steps in the correct order for your admitted patient

Order

C.Reassess Q30 minx2 then Q4hrs for effectivness

B. Acknowledge the order for narcotic pain medicine

A.Bring the medication and a nurse for the dual sign off of the IV narcotic infusion

bacD

ABCD

acbd

Choose

What secret code was formed with the above order?

Not the correct orderTry again!

Again!

New number obtained

Continue

Congratulations! You've got your last secret number to open the briefcase.

Correct

you've almost made it, your secret agent's badge is just within reach...

secret agentescape room

map/misions

Final Mission

Password?

What is the key?

Enter the correct numbers

Click Exit Course X on the top right hand side of the screen.

You have completed the controlled substances module. Congratulations!

Signature:

Pain Be Controlled!

Date: Today

Name: VUMC Nurse

S.P.Y

secret agent

Mission accomplished!

If you leave you will have to start all over againAre you sure you want to leave?

Exit

Continue

Are you giving up?You were very close to becoming a real secret agent.