W i n d s o r  N e p h r o l o g y

 

                                                                                                R u l e s   f o r   r e n a l   p a g i n g

 

1.  MRP vs. Renal Issue

 

Issues that are renal-related should be paged to the renal service.  All other issues should be paged to the MRP.

2.  Who to page

 

Please check the website for availability of different disciplines, associated with the renal service.  In general, please follow the listed guidelines below during working hours:

  • Page NP for non- urgent clinical issues
  • Page MD for urgent clinical issues during and after hours
  • Page Pharmacist for medication related issues
  • Page the dietitian for diet-related issues
  • Check website for availability (www.windsornephron.com)

 

3.  When to page and Grouping pages

 

On any ward where multiple renal patients are present all non-urgent pages should be grouped together and called at one time.  The renal service will expect these pages at 10 a.m., 2 p.m. and 8 p.m.

4. Use website before answering service

 

Always use the website(www.windsornephron.com), prior to the answering service when paging the physician on call, as these pages are received instantaneously over the Internet.  If difficulties with the website occur, only then should the answering service be used.

 

5.  SBAR 

 

The use of the SBAR communication tool should occur each time the renal service is paged.

 

6.  Identifying Patients

 

With every page, you must include the patient's full last name and room number to avoid confusion and errors in patient care.  No first initial or name is to be used for confidentiality.

 

7.  Appropriateness of Pages

 

If there is any question regarding whether an issue needs to be paged to the renal service, particularly after hours pages, consultation with more senior nursing staff is suggested to ensure appropriateness of pages.  If any issue is non-urgent in nature, it should wait till the next day and communicated during working hours -- preferably on rounds or to the nurse practitioner.

 

8.  Medication Issues

 

For any medication issue, always have the MAR present prior to communication with the renal service. If there is a Coumadin issue – have last two INR’s and last two Coumadin doses on hand.  During working hours, the pharmacist should be made aware of any medication-related issues.

 

9.  Unstable Patients

 

For any unstable patient, if there are serious concerns about deterioration in clinical status, the CCOT team should be paged according to their established guidelines to assess the patient.  The MRP should be notified of the status of the patient and the renal service should be notified if there are any concerns about renal-related issues.