Afternoon CNA Break

DRT 
 Composed by Marianna

• Wash hands
• Check to see if there are tissues in SC bucket and bring out SC and stool
• Water management / take out blue hot dog pillow/rice in microwave
• Prep 3 double paper towels and alcohol swab- put on dinner table
• Move blind and take Tobii away

Here's how you should position Tobii:

• Pull Don forward to about where the dinner table begins
• Mouth suction
• Lung Suction
• After LS…
• Open burp tube
• Lean Don forward
• Fix arms
• Lower feet 
• Put shoe strap around heels
• Take off seat-belt and loosen the left strap of seat-belt enough to drape over the arm of the WC
• Take out catheter bag (pull tube out from under legs so it’s sitting in between legs when draining) 
• Put tissues from tube on Bertha to reuse
• Hang leg strap on SC
• Put urine bag in bathroom
• Rip a small square off a paper towel in bathroome
• Use square from paper towel to plug condom
• Tuck condom into diaper
• Take off burp tube (put in sink & rinse with water) and take off trach roll
• Mouth suction

TRANSFER

• Put Don's feet on your shoulders
• Put strap on foot pedals and lower them all the way
• Have PA hold forehead
• Lean forward all the way- feet down so toes touch ground (may have to pull a little)
• Sandwich legs with yours
• Take off right arm lateral
• Transfer to Shower Chair

IN SHOWER CHAIR

• Hands in lap/shoes off/ lift feet and slide stool from behind legs/ diaper and shorts below knees
• Pull plug out of condom, do not take the condom off
• Check for “spot” in diaper
• Put double paper towel over junk into bucket
• Pull diaper and shorts over hands
• Belly rub over large intestine; with force. Watch video below 
• Batman pillow/ pull chair forward one notch/ lean Don forward
• Cross hands (ring hand on top)/ put hands over knees/tuck double paper towel into hand (tuck by thumb, should hang forward)
• Butt lift both sides
• Fold Batman pillow
• Check everything! (condom, push pillow down, socks over toes, toes not over stools, no clips stabbing, blue trach tube to the right of the white one & yellow tube up)

While Waiting

• Empty suction bowl and fill jar
• Get burp tube ready
• Empty catheter bag
• get prep H, baby wipes 

Complete Shower Chair

• Remove pillow/ wipe lips with paper towel from hand/ lean back
• Get catheter strap
• Connect catheter bag/ push condom on ALL the way
• Diaper and shorts up to hold hands
• Wipe away until baby wipe is totally clean
• Shoes on
• Mouth suction
• Get black box for transfer/ push condom all the way on one more time

Transfer!

• Use Black Box to Transfer
• Sandwich legs
• PA guide hips back as far as possible
• Push knees to get Don as far back as possible

Wheelchair Comfort

• Pull down and Straighten out the back of his shirt
• Lean back a little
• Feet on pedals
• Check and straighten condom, cath bag and tissues around blue tab position
• Roll under trach
• Straighten condom
• Left butt lift
• Seatbelt (make sure shorts are under the strap)
• Cross arms and lean all the way back
• Push HARD 2 times with hands just below kneecap & ask if it’s okay

THE SHOULDER TWIST 

• Put both of your hands on Don's shoulders 
• Put his left shoulder back while pushing right shoulder forward
• Lift up Don's right hand and push right lateral in.
  Push the right elbow rest in position. 
• Place blue roll pillow by left thigh
• Lung Suction
• Close burp tube
• Feet almost all the way up. Tilt head back until you can reach him, your decision. 
• Shoes off, blanket?
• Adjust Neck Brace (Chin lift to tighten) /NEW bib
• Move Wheelchair to big wheel in blue floor tape
• AM- Place black blind behind chair to stop glare on computer screen
• PM- Spin Don to face TV (hold power cord/ big wheels in line with blue tap)

Set Up Tobii

FINAL-

• Mouth suction
• Chapstick