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Larkin Health System Badge Buddy

Keep essential hospital emergency codes within reach during every shift. This Larkin Health System Badge Buddy is designed as a quick-reference card for nurses, students, residents, clinical staff, and healthcare workers who need fast access to emergency code reminders while on the floor.

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In Emergency, Dial *100
Brown
Hazardous Spill
Black
Power Failure
Blue
Cardiac Arrest
Dr. Strong
Aggressive Patient
Code Fall
Patient Falls
Green
Do Not Use Water
Orange
Bomb Threat
Pink
Abandoned Baby
Purple
Internal / External Disaster
Red
Fire
Stroke Alert
Patient Having a Stroke
Silver
Active Shooter
Yellow
Elopement / Missing Person
Sepsis
Patient with Suspected Sepsis
ComplianceMerlyn Viera
HIPAA PrivacyMerlyn Viera
HIPAA SecurityOrlando Suarez
LaboratoryEduardo Dumenigo
MRI SafetyNelson Rodriguez
Patient SafetyCrucita Martinez
Radiation SafetyIris Cardona
Gamma Knife RSODr. Xiaodong Wu
Risk Manager DesigneeMerlyn Viera
SafetyChris Camacho

2026 Hospital National Performance Goals (NPGs)

1 Correct care at the correct time
The hospital ensures that the correct patient receives the correct care at the correct time.
2 Culture of safety
The governing body and leadership team foster a culture of safety.
3 Emergency management program
The hospital has an emergency management program.
4 Excellent health outcomes for all
The hospital prioritizes excellent health outcomes for all.
5 Infection prevention and control
The hospital prioritizes infection prevention and control.
6 Pain management & safe prescribing
The hospital prioritizes pain management and safe prescribing practices.
7 Patient's right to safe, informed care
The hospital respects the patient's right to safe, informed care.
8 Reduce risk for suicide
The hospital reduces the risk for suicide.
9 Safe transplant practices
The hospital develops and implements safe transplant practices.
10 Waived testing safely & consistently
The hospital performs waived testing in a safe and consistent manner.
11 Workplace and patient safety
The hospital maintains workplace and patient safety.
12 Adequate, competent staffing
The hospital is staffed to meet the needs of the patients it serves, and staff are competent to provide safe, quality care.
13 Safe imaging services
The hospital safely performs imaging services.
14 Medication management focused on safety
The hospital has a medication management program that focuses on safety.
Clinical Tools
Morse Fall Scale Score: 0 No risk
Padua VTE Score Score: 0 Low risk
Quick Reference

B.E. F.A.S.T.

  • BBalance - Sudden loss of balance or coordination
  • EEyes - Sudden vision change, blurred or double vision, loss of vision in one or both eyes
  • FFace - Facial drooping or numbness - ask the person to smile
  • AArms - Arm or leg weakness - ask the person to raise both arms, does one drift down?
  • SSpeech - Slurred speech, trouble speaking, or hard to understand
  • TTime - Time is brain. Call a Stroke Alert immediately and note the time of symptom onset.

SIRS / Sepsis / Severe

SIRS Criteria (Any 2 of the following)
  • Temp. >100.9 °F or <96.8 °F
  • Pulse >90 BPM
  • Resp. Rate >20 BPM
  • WBC >12,000 or <4,000
Sepsis (2 SIRS + Infection)
  • UTI
  • Pneumonia
  • Wound / skin infection
  • Redness, swelling, drainage
  • Bone / joint symptoms
  • New abdominal pain
  • Shortness of breath
  • Cough
  • Vomiting
  • Diarrhea
Severe Sepsis (Sepsis + Organ Dysfunction)
  • Lactate >2.0
  • SBP <90
  • MAP <65, or SBP decrease >40 from baseline
  • Creatinine >2.0
Sepsis 1-Hour Bundle Goal (Complete within 1 hour)
  • Measure lactate
  • Blood cultures
  • Antibiotics
  • IV fluids 30 mL/kg
  • Vasopressors if hypotensive after IV bolus

Per DX

Inpatient admission criteria by diagnosis. Reference for status determination - final decisions rest with the admitting physician and case management.

  • ACS - HEART 7–10 or new ECG ischemia or new EF ≤40% or troponin ≥ULN or NSTEMI or unstable angina AND anticoag or cath.
  • AKI - Cr ≥3× baseline or Cr ≥1.5× & ≥4 AND IVF; or Cr ≥2× / GFR ↓ ≥50% AND initial HD or diuretic ≥2×/24h or immunosuppressant.
  • Arrhythmia (Atrial) - Persistent HR ≥110 or proarrhythmic risk or pacemaker; AF + acute HF NYHA III/IV; SVT; sinus dysfunction; sotalol/dofetilide start.
  • Asthma - Impending resp failure or status asthmaticus or PaCO₂ ≥42 or PEF/FEV₁ <40% AND Heliox or MV/NIPPV or continuous SABA.
  • Bowel Obstruction - Obstruction confirmed by imaging AND NPO or NGT & IV fluid.
  • Cellulitis - Immunocompromised or over prosthesis/implant/surgical device or orbital cellulitis by imaging AND anti-infective.
  • COPD - O₂ <89% or PaO₂ ≤55 or RR >24 or ↑ WOB (can't speak full sentences or accessory muscles) post-ED tx AND bronchodilators + steroid; ± risk factors.
  • Diverticulitis - Complicated by CT or comorbid (ESLD, immunocompromised, ESRD) or organ dysfunction (2mod/1 high risk findings) or LA >ULN AND IV Abx or abscess drainage ≤24h.
  • DVT - Extensive DVT & neurovascular checks ≥6×/24h; splanchnic VT; heparin drip (APLA, bleeding risk, BMI ≥40, CrCl ≤30); HIT; IVC filter placement.
  • GI Bleeding - Hct <21% / Hb <7 or INR ≥2 or AMS or orthostatic hypotension or syncope AND transfusion or endoscopy/colonoscopy.
  • Heart Failure - New HF w/ sx + BNP >ULN or +CXR AND diuretic or HD; acute-on-chronic w/ persistent dyspnea or O₂ <90% & inadequate diuresis or risk factors (Cr ≥1.5, HR 100-120, SBP <120, Na <130, BUN ≥43, Frailty or Mental illness) AND diuretic ≥2, escal. or change w/ HD.
  • HTN - HTN emergency & Cr ≥3× or micro hematuria/proteinuria or aortic dissection or acute HF or encephalopathy or papilledema or seizure AND continuous anti-HTN or invasive monitoring.
  • Pancreatitis - Chronic flare w/ refractory pain or protracted vomiting & IVFs; or high risk w/ risk factors (BUN >20, Hct ≥44%, AMS, CBD/pancreatic duct stone) AND goal-directed IVF + PCA/analgesic ≥4×/24h.
  • PE - Anticoag + HF requiring IV diuretic or O₂ ≤91%; heparin drip (APLA, bleeding, BMI ≥40, CrCl ≤30); HIT; IVC filter placement.
  • Pneumonia - O₂ <89% or PaO₂ <56 or complicated PNA (i.e. ≥2 lobes) or PSI ≥91 or ≥3 CURB-65 or immunocompromised AND IV abx or PO Abx + IVFs or O₂.
  • Pyelo / C.UTI - (+) BCX or pregnancy ≥24wk or H/o stent or urinary obstruction or organ dysfunction & ≥2 SIRS AND UCx pending + abx + IVF.
  • Sepsis - (+) BCX or organ dysfunction (Cr ≥1.5×, AMS, PLT <150K, TB ≥1.2, O₂ ≤91%) or LA >ULN & ≥2 SIRS AND anti-infective + IVFs.
  • Stroke - New persistent neuro deficit (movement, speech, gait, AMS, GCS 9–14, paresis, vision) & CT/MRI AND antiplatelet or anticoagulant.

0-10 NRS

ScoreLevelDescription
0No painNo hurt
1–3MildNagging, annoying, but doesn't interfere with daily activities
4–6ModerateInterferes significantly with daily activities
7–9SevereDisabling - unable to perform daily activities
10Worst possibleUnbearable - emergency

For non-verbal or pediatric patients, consider Wong-Baker FACES, FLACC, or PAINAD per facility policy.

Suicide Assessment 5-Step Eval & Triage

  1. Identify Risk Factors - Note those that can be modified to reduce risk.
  2. Identify Protective Factors - Note those that can be enhanced.
  3. Conduct Suicide Inquiry - Assess suicidal thoughts, plans, behavior, and intent.
  4. Determine Risk Level / Intervention - Determine risk and choose an appropriate intervention to address and reduce risk.
  5. Document - Assessment of risk, rationale, intervention, and follow-up.

National Suicide Prevention Lifeline 988

If you discover a fire

R.A.C.E.

  • RRescue
  • AAlarm
  • CContain
  • EExtinguish

P.A.S.S.

  • PPull
  • AAim
  • SSqueeze
  • SSweep

WHO 5 Moments

  1. Before touching a patient - Protects the patient from harmful germs carried on your hands.
  2. Before clean / aseptic procedure - Protects the patient from harmful germs, including their own, entering the body.
  3. After body fluid exposure risk - Protects you and the healthcare environment from the patient's harmful germs.
  4. After touching a patient - Protects you and the healthcare environment from the patient's germs.
  5. After touching patient surroundings - Protects you and the healthcare environment, even if the patient was not touched.
  • Soap & water - Wash for 40–60 seconds when hands are visibly soiled, after restroom use, or after caring for a patient with C. difficile.
  • Alcohol-based rub - Use for 20–30 seconds when hands are not visibly soiled. Preferred method between most patient contacts.

Transmission-based

Standard Apply to all patients
  • When: Every patient, every encounter
  • PPE: Hand hygiene before/after contact. Gloves, gown, mask, eye protection as risk dictates.
  • Examples: Foundational practice for all care
Contact Direct or indirect contact
  • Room: Private room preferred
  • PPE: Gown + gloves on entry, removed before exit
  • Examples: MRSA, VRE, C. difficile (soap & water for hands), RSV, scabies, draining wounds
Droplet Large respiratory droplets
  • Room: Private room; curtain drawn; ≥3 ft separation
  • PPE: Surgical mask on entry. Patient wears mask during transport.
  • Examples: Influenza, pertussis, mumps, meningococcal disease, group A strep
Airborne Small particles that linger
  • Room: Airborne Infection Isolation Room (AIIR) - negative pressure, door closed
  • PPE: Fit-tested N95 or PAPR. Patient wears surgical mask during transport.
  • Examples: Tuberculosis, measles, varicella (chickenpox), disseminated zoster
Protective Neutropenic / reverse isolation
  • Room: Positive-pressure room with HEPA filtration
  • PPE: Strict hand hygiene; no fresh flowers or fresh fruit; restrict ill visitors
  • Examples: Severely immunocompromised, stem cell transplant, severe neutropenia

Combine multiple types when needed (e.g., SARS, measles + contact). When in doubt, ask Infection Prevention.

Don & Doff

Don PPE (put on in this order)

  1. Gown
  2. Mask
  3. Goggles
  4. Gloves

Doff PPE (take off in this order)

  1. Gloves
  2. Goggles
  3. Gown
  4. Mask

Use only articles required for each isolation level: Contact, Droplet, or Airborne. Perform hand hygiene before donning and after doffing each piece. Follow CDC Guidelines for Isolation Precautions.

R.A.I.N. & GHS

R.A.I.N.

  • RRecognize the presence of a hazard
  • AAvoid exposure through use of protection
  • IIsolate hazards by securing the area
  • NNotify appropriate higher-level person

GHS pictograms

  • Exploding Bomb - Explosion or reactivity hazards
  • Flame - Fire hazards
  • Flame Over Circle - Oxidizers
  • Gas Cylinder - Gases under pressure
  • Corrosion - Corrosive to metals, skin, eyes
  • Skull & Crossbones - Acute toxicity (fatal/toxic)
  • Health Hazard - Serious long-term health effects
  • Exclamation Mark - Less serious health effects / ozone
  • Environment - Aquatic toxicity
  • Biohazard - Infectious materials & organisms
In Emergency, Dial 50
Black
Bomb Threat
Blue
Cardiac Arrest
Green
Internal / External Alert
Orange
Hazmat / Decon Alert
Pink
Child Abduction
Purple
ED Capacity
Red
Fire
Silver
Active Shooter
Rapid Response
Patient in Distress
Stroke Alert
Possible Stroke Alert (Team Alert)
Sepsis
Possible Sepsis Alert (Team Alert)
Dr. Strong
Aggressive Patient / Danger to Self
Heart
Possible STEMI
STEMI
Confirmed STEMI
CEOYoely Hernandez
CNODanay Rodriguez-Arritola
Compliance / Patient SafetyAnyuaniet Morales
HIPAA PrivacyJeniffer Gonzalez
Laboratory SafetyIsbeth Hernandez
MRI SafetyMariam Velazquez-Rodriguez
Radiation SafetyNelson Rodriguez
VP HR & DEI OfficerIris Cardona
Emergency / Safety OfficerClaudette Bombino

2026 Hospital National Performance Goals (NPGs)

1 Correct care at the correct time
The hospital ensures that the correct patient receives the correct care at the correct time.
2 Culture of safety
The governing body and leadership team foster a culture of safety.
3 Emergency management program
The hospital has an emergency management program.
4 Excellent health outcomes for all
The hospital prioritizes excellent health outcomes for all.
5 Infection prevention and control
The hospital prioritizes infection prevention and control.
6 Pain management & safe prescribing
The hospital prioritizes pain management and safe prescribing practices.
7 Patient's right to safe, informed care
The hospital respects the patient's right to safe, informed care.
8 Reduce risk for suicide
The hospital reduces the risk for suicide.
9 Safe transplant practices
The hospital develops and implements safe transplant practices.
10 Waived testing safely & consistently
The hospital performs waived testing in a safe and consistent manner.
11 Workplace and patient safety
The hospital maintains workplace and patient safety.
12 Adequate, competent staffing
The hospital is staffed to meet the needs of the patients it serves, and staff are competent to provide safe, quality care.
13 Safe imaging services
The hospital safely performs imaging services.
14 Medication management focused on safety
The hospital has a medication management program that focuses on safety.
Clinical Tools
Morse Fall Scale Score: 0 No risk
Padua VTE Score Score: 0 Low risk
Quick Reference

B.E. F.A.S.T.

  • BBalance - Sudden loss of balance or coordination
  • EEyes - Sudden vision change, blurred or double vision, loss of vision in one or both eyes
  • FFace - Facial drooping or numbness - ask the person to smile
  • AArms - Arm or leg weakness - ask the person to raise both arms, does one drift down?
  • SSpeech - Slurred speech, trouble speaking, or hard to understand
  • TTime - Time is brain. Call a Stroke Alert immediately and note the time of symptom onset.

SIRS / Sepsis / Severe

SIRS Criteria (Any 2 of the following)
  • Temp. >100.9 °F or <96.8 °F
  • Pulse >90 BPM
  • Resp. Rate >20 BPM
  • WBC >12,000 or <4,000
Sepsis (2 SIRS + Infection)
  • UTI
  • Pneumonia
  • Wound / skin infection
  • Redness, swelling, drainage
  • Bone / joint symptoms
  • New abdominal pain
  • Shortness of breath
  • Cough
  • Vomiting
  • Diarrhea
Severe Sepsis (Sepsis + Organ Dysfunction)
  • Lactate >2.0
  • SBP <90
  • MAP <65, or SBP decrease >40 from baseline
  • Creatinine >2.0
Sepsis 1-Hour Bundle Goal (Complete within 1 hour)
  • Measure lactate
  • Blood cultures
  • Antibiotics
  • IV fluids 30 mL/kg
  • Vasopressors if hypotensive after IV bolus

Per DX

Inpatient admission criteria by diagnosis. Reference for status determination - final decisions rest with the admitting physician and case management.

  • ACS - HEART 7–10 or new ECG ischemia or new EF ≤40% or troponin ≥ULN or NSTEMI or unstable angina AND anticoag or cath.
  • AKI - Cr ≥3× baseline or Cr ≥1.5× & ≥4 AND IVF; or Cr ≥2× / GFR ↓ ≥50% AND initial HD or diuretic ≥2×/24h or immunosuppressant.
  • Arrhythmia (Atrial) - Persistent HR ≥110 or proarrhythmic risk or pacemaker; AF + acute HF NYHA III/IV; SVT; sinus dysfunction; sotalol/dofetilide start.
  • Asthma - Impending resp failure or status asthmaticus or PaCO₂ ≥42 or PEF/FEV₁ <40% AND Heliox or MV/NIPPV or continuous SABA.
  • Bowel Obstruction - Obstruction confirmed by imaging AND NPO or NGT & IV fluid.
  • Cellulitis - Immunocompromised or over prosthesis/implant/surgical device or orbital cellulitis by imaging AND anti-infective.
  • COPD - O₂ <89% or PaO₂ ≤55 or RR >24 or ↑ WOB (can't speak full sentences or accessory muscles) post-ED tx AND bronchodilators + steroid; ± risk factors.
  • Diverticulitis - Complicated by CT or comorbid (ESLD, immunocompromised, ESRD) or organ dysfunction (2mod/1 high risk findings) or LA >ULN AND IV Abx or abscess drainage ≤24h.
  • DVT - Extensive DVT & neurovascular checks ≥6×/24h; splanchnic VT; heparin drip (APLA, bleeding risk, BMI ≥40, CrCl ≤30); HIT; IVC filter placement.
  • GI Bleeding - Hct <21% / Hb <7 or INR ≥2 or AMS or orthostatic hypotension or syncope AND transfusion or endoscopy/colonoscopy.
  • Heart Failure - New HF w/ sx + BNP >ULN or +CXR AND diuretic or HD; acute-on-chronic w/ persistent dyspnea or O₂ <90% & inadequate diuresis or risk factors (Cr ≥1.5, HR 100-120, SBP <120, Na <130, BUN ≥43, Frailty or Mental illness) AND diuretic ≥2, escal. or change w/ HD.
  • HTN - HTN emergency & Cr ≥3× or micro hematuria/proteinuria or aortic dissection or acute HF or encephalopathy or papilledema or seizure AND continuous anti-HTN or invasive monitoring.
  • Pancreatitis - Chronic flare w/ refractory pain or protracted vomiting & IVFs; or high risk w/ risk factors (BUN >20, Hct ≥44%, AMS, CBD/pancreatic duct stone) AND goal-directed IVF + PCA/analgesic ≥4×/24h.
  • PE - Anticoag + HF requiring IV diuretic or O₂ ≤91%; heparin drip (APLA, bleeding, BMI ≥40, CrCl ≤30); HIT; IVC filter placement.
  • Pneumonia - O₂ <89% or PaO₂ <56 or complicated PNA (i.e. ≥2 lobes) or PSI ≥91 or ≥3 CURB-65 or immunocompromised AND IV abx or PO Abx + IVFs or O₂.
  • Pyelo / C.UTI - (+) BCX or pregnancy ≥24wk or H/o stent or urinary obstruction or organ dysfunction & ≥2 SIRS AND UCx pending + abx + IVF.
  • Sepsis - (+) BCX or organ dysfunction (Cr ≥1.5×, AMS, PLT <150K, TB ≥1.2, O₂ ≤91%) or LA >ULN & ≥2 SIRS AND anti-infective + IVFs.
  • Stroke - New persistent neuro deficit (movement, speech, gait, AMS, GCS 9–14, paresis, vision) & CT/MRI AND antiplatelet or anticoagulant.

0-10 NRS

ScoreLevelDescription
0No painNo hurt
1–3MildNagging, annoying, but doesn't interfere with daily activities
4–6ModerateInterferes significantly with daily activities
7–9SevereDisabling - unable to perform daily activities
10Worst possibleUnbearable - emergency

For non-verbal or pediatric patients, consider Wong-Baker FACES, FLACC, or PAINAD per facility policy.

Suicide Assessment 5-Step Eval & Triage

  1. Identify Risk Factors - Note those that can be modified to reduce risk.
  2. Identify Protective Factors - Note those that can be enhanced.
  3. Conduct Suicide Inquiry - Assess suicidal thoughts, plans, behavior, and intent.
  4. Determine Risk Level / Intervention - Determine risk and choose an appropriate intervention to address and reduce risk.
  5. Document - Assessment of risk, rationale, intervention, and follow-up.

National Suicide Prevention Lifeline 988

If you discover a fire

R.A.C.E.

  • RRescue
  • AAlarm
  • CContain
  • EExtinguish

P.A.S.S.

  • PPull
  • AAim
  • SSqueeze
  • SSweep

WHO 5 Moments

  1. Before touching a patient - Protects the patient from harmful germs carried on your hands.
  2. Before clean / aseptic procedure - Protects the patient from harmful germs, including their own, entering the body.
  3. After body fluid exposure risk - Protects you and the healthcare environment from the patient's harmful germs.
  4. After touching a patient - Protects you and the healthcare environment from the patient's germs.
  5. After touching patient surroundings - Protects you and the healthcare environment, even if the patient was not touched.
  • Soap & water - Wash for 40–60 seconds when hands are visibly soiled, after restroom use, or after caring for a patient with C. difficile.
  • Alcohol-based rub - Use for 20–30 seconds when hands are not visibly soiled. Preferred method between most patient contacts.

Transmission-based

Standard Apply to all patients
  • When: Every patient, every encounter
  • PPE: Hand hygiene before/after contact. Gloves, gown, mask, eye protection as risk dictates.
  • Examples: Foundational practice for all care
Contact Direct or indirect contact
  • Room: Private room preferred
  • PPE: Gown + gloves on entry, removed before exit
  • Examples: MRSA, VRE, C. difficile (soap & water for hands), RSV, scabies, draining wounds
Droplet Large respiratory droplets
  • Room: Private room; curtain drawn; ≥3 ft separation
  • PPE: Surgical mask on entry. Patient wears mask during transport.
  • Examples: Influenza, pertussis, mumps, meningococcal disease, group A strep
Airborne Small particles that linger
  • Room: Airborne Infection Isolation Room (AIIR) - negative pressure, door closed
  • PPE: Fit-tested N95 or PAPR. Patient wears surgical mask during transport.
  • Examples: Tuberculosis, measles, varicella (chickenpox), disseminated zoster
Protective Neutropenic / reverse isolation
  • Room: Positive-pressure room with HEPA filtration
  • PPE: Strict hand hygiene; no fresh flowers or fresh fruit; restrict ill visitors
  • Examples: Severely immunocompromised, stem cell transplant, severe neutropenia

Combine multiple types when needed (e.g., SARS, measles + contact). When in doubt, ask Infection Prevention.

Don & Doff

Don PPE (put on in this order)

  1. Gown
  2. Mask
  3. Goggles
  4. Gloves

Doff PPE (take off in this order)

  1. Gloves
  2. Goggles
  3. Gown
  4. Mask

Use only articles required for each isolation level: Contact, Droplet, or Airborne. Perform hand hygiene before donning and after doffing each piece. Follow CDC Guidelines for Isolation Precautions.

R.A.I.N. & GHS

R.A.I.N.

  • RRecognize the presence of a hazard
  • AAvoid exposure through use of protection
  • IIsolate hazards by securing the area
  • NNotify appropriate higher-level person

GHS pictograms

  • Exploding Bomb - Explosion or reactivity hazards
  • Flame - Fire hazards
  • Flame Over Circle - Oxidizers
  • Gas Cylinder - Gases under pressure
  • Corrosion - Corrosive to metals, skin, eyes
  • Skull & Crossbones - Acute toxicity (fatal/toxic)
  • Health Hazard - Serious long-term health effects
  • Exclamation Mark - Less serious health effects / ozone
  • Environment - Aquatic toxicity
  • Biohazard - Infectious materials & organisms
In Emergency, Dial 5301
Black
Power Outage
Blue
Cardiac Arrest
Dr. Strong
Aggressive Patient
Green
Do Not Use Water
Orange
Bomb Threat
Pink
Abandoned Baby
Purple
Internal / External Disaster
Red
Fire
Silver
Active Shooter
Stroke Alert
Possible Stroke Alert
Sepsis
Possible Sepsis Alert
CEOAnia Gonzalez
CNOAxel Rodriguez
Risk ManagementMelvin Hernandez
Safety & ComplianceMichely Hernandez
HIPAA PrivacyAtasa Falconer
HIPAA SecurityOrlando Suarez
Patient Safety & ADAAxel Rodriguez

2026 Behavioral Health Care National Patient Safety Goals

01.01.01 Identify individuals served correctly
Use at least two ways to identify individuals served. For example, use the individual's name and date of birth. This is done to make sure that each individual served gets the correct medicine and treatment.
03.06.01 Use medicines safely
Record and pass along correct information about an individual's medicines. Find out what medicines the individual served is taking. Compare those medicines to new medicines given to the individual served. Give the individual served written information about the medicines they need to take. Tell the individual served it is important to bring their up-to-date list of medicines every time they visit a doctor.
07.01.01 Prevent infection
Use the hand cleaning guidelines from the Centers for Disease Control and Prevention or the World Health Organization. Set goals for improving hand cleaning.
15.01.01 Identify individuals served safety risks
Reduce the risk for suicide.
16.01.01 Improve health outcomes for all
Improving health outcomes for all is a quality and patient safety priority. For example, health care disparities in the patient population are identified and a written plan describes ways to improve health outcomes for all.

Mission: To provide compassionate care of the highest quality.

Vision: Larkin Community Hospital Behavioral Health Services will be recognized as progressive in our response to changing healthcare needs of our community. We will work without medical staff as partners in the pursuit of healthcare experience.

Clinical Tools
Morse Fall Scale Score: 0 No risk
Padua VTE Score Score: 0 Low risk
Quick Reference

B.E. F.A.S.T.

  • BBalance - Sudden loss of balance or coordination
  • EEyes - Sudden vision change, blurred or double vision, loss of vision in one or both eyes
  • FFace - Facial drooping or numbness - ask the person to smile
  • AArms - Arm or leg weakness - ask the person to raise both arms, does one drift down?
  • SSpeech - Slurred speech, trouble speaking, or hard to understand
  • TTime - Time is brain. Call a Stroke Alert immediately and note the time of symptom onset.

SIRS / Sepsis / Severe

SIRS Criteria (Any 2 of the following)
  • Temp. >100.9 °F or <96.8 °F
  • Pulse >90 BPM
  • Resp. Rate >20 BPM
  • WBC >12,000 or <4,000
Sepsis (2 SIRS + Infection)
  • UTI
  • Pneumonia
  • Wound / skin infection
  • Redness, swelling, drainage
  • Bone / joint symptoms
  • New abdominal pain
  • Shortness of breath
  • Cough
  • Vomiting
  • Diarrhea
Severe Sepsis (Sepsis + Organ Dysfunction)
  • Lactate >2.0
  • SBP <90
  • MAP <65, or SBP decrease >40 from baseline
  • Creatinine >2.0
Sepsis 1-Hour Bundle Goal (Complete within 1 hour)
  • Measure lactate
  • Blood cultures
  • Antibiotics
  • IV fluids 30 mL/kg
  • Vasopressors if hypotensive after IV bolus

Per DX

Inpatient admission criteria by diagnosis. Reference for status determination - final decisions rest with the admitting physician and case management.

  • ACS - HEART 7–10 or new ECG ischemia or new EF ≤40% or troponin ≥ULN or NSTEMI or unstable angina AND anticoag or cath.
  • AKI - Cr ≥3× baseline or Cr ≥1.5× & ≥4 AND IVF; or Cr ≥2× / GFR ↓ ≥50% AND initial HD or diuretic ≥2×/24h or immunosuppressant.
  • Arrhythmia (Atrial) - Persistent HR ≥110 or proarrhythmic risk or pacemaker; AF + acute HF NYHA III/IV; SVT; sinus dysfunction; sotalol/dofetilide start.
  • Asthma - Impending resp failure or status asthmaticus or PaCO₂ ≥42 or PEF/FEV₁ <40% AND Heliox or MV/NIPPV or continuous SABA.
  • Bowel Obstruction - Obstruction confirmed by imaging AND NPO or NGT & IV fluid.
  • Cellulitis - Immunocompromised or over prosthesis/implant/surgical device or orbital cellulitis by imaging AND anti-infective.
  • COPD - O₂ <89% or PaO₂ ≤55 or RR >24 or ↑ WOB (can't speak full sentences or accessory muscles) post-ED tx AND bronchodilators + steroid; ± risk factors.
  • Diverticulitis - Complicated by CT or comorbid (ESLD, immunocompromised, ESRD) or organ dysfunction (2mod/1 high risk findings) or LA >ULN AND IV Abx or abscess drainage ≤24h.
  • DVT - Extensive DVT & neurovascular checks ≥6×/24h; splanchnic VT; heparin drip (APLA, bleeding risk, BMI ≥40, CrCl ≤30); HIT; IVC filter placement.
  • GI Bleeding - Hct <21% / Hb <7 or INR ≥2 or AMS or orthostatic hypotension or syncope AND transfusion or endoscopy/colonoscopy.
  • Heart Failure - New HF w/ sx + BNP >ULN or +CXR AND diuretic or HD; acute-on-chronic w/ persistent dyspnea or O₂ <90% & inadequate diuresis or risk factors (Cr ≥1.5, HR 100-120, SBP <120, Na <130, BUN ≥43, Frailty or Mental illness) AND diuretic ≥2, escal. or change w/ HD.
  • HTN - HTN emergency & Cr ≥3× or micro hematuria/proteinuria or aortic dissection or acute HF or encephalopathy or papilledema or seizure AND continuous anti-HTN or invasive monitoring.
  • Pancreatitis - Chronic flare w/ refractory pain or protracted vomiting & IVFs; or high risk w/ risk factors (BUN >20, Hct ≥44%, AMS, CBD/pancreatic duct stone) AND goal-directed IVF + PCA/analgesic ≥4×/24h.
  • PE - Anticoag + HF requiring IV diuretic or O₂ ≤91%; heparin drip (APLA, bleeding, BMI ≥40, CrCl ≤30); HIT; IVC filter placement.
  • Pneumonia - O₂ <89% or PaO₂ <56 or complicated PNA (i.e. ≥2 lobes) or PSI ≥91 or ≥3 CURB-65 or immunocompromised AND IV abx or PO Abx + IVFs or O₂.
  • Pyelo / C.UTI - (+) BCX or pregnancy ≥24wk or H/o stent or urinary obstruction or organ dysfunction & ≥2 SIRS AND UCx pending + abx + IVF.
  • Sepsis - (+) BCX or organ dysfunction (Cr ≥1.5×, AMS, PLT <150K, TB ≥1.2, O₂ ≤91%) or LA >ULN & ≥2 SIRS AND anti-infective + IVFs.
  • Stroke - New persistent neuro deficit (movement, speech, gait, AMS, GCS 9–14, paresis, vision) & CT/MRI AND antiplatelet or anticoagulant.

0-10 NRS

ScoreLevelDescription
0No painNo hurt
1–3MildNagging, annoying, but doesn't interfere with daily activities
4–6ModerateInterferes significantly with daily activities
7–9SevereDisabling - unable to perform daily activities
10Worst possibleUnbearable - emergency

For non-verbal or pediatric patients, consider Wong-Baker FACES, FLACC, or PAINAD per facility policy.

Suicide Assessment 5-Step Eval & Triage

  1. Identify Risk Factors - Note those that can be modified to reduce risk.
  2. Identify Protective Factors - Note those that can be enhanced.
  3. Conduct Suicide Inquiry - Assess suicidal thoughts, plans, behavior, and intent.
  4. Determine Risk Level / Intervention - Determine risk and choose an appropriate intervention to address and reduce risk.
  5. Document - Assessment of risk, rationale, intervention, and follow-up.

National Suicide Prevention Lifeline 988

If you discover a fire

R.A.C.E.

  • RRescue
  • AAlarm
  • CContain
  • EExtinguish

P.A.S.S.

  • PPull
  • AAim
  • SSqueeze
  • SSweep

WHO 5 Moments

  1. Before touching a patient - Protects the patient from harmful germs carried on your hands.
  2. Before clean / aseptic procedure - Protects the patient from harmful germs, including their own, entering the body.
  3. After body fluid exposure risk - Protects you and the healthcare environment from the patient's harmful germs.
  4. After touching a patient - Protects you and the healthcare environment from the patient's germs.
  5. After touching patient surroundings - Protects you and the healthcare environment, even if the patient was not touched.
  • Soap & water - Wash for 40–60 seconds when hands are visibly soiled, after restroom use, or after caring for a patient with C. difficile.
  • Alcohol-based rub - Use for 20–30 seconds when hands are not visibly soiled. Preferred method between most patient contacts.

Transmission-based

Standard Apply to all patients
  • When: Every patient, every encounter
  • PPE: Hand hygiene before/after contact. Gloves, gown, mask, eye protection as risk dictates.
  • Examples: Foundational practice for all care
Contact Direct or indirect contact
  • Room: Private room preferred
  • PPE: Gown + gloves on entry, removed before exit
  • Examples: MRSA, VRE, C. difficile (soap & water for hands), RSV, scabies, draining wounds
Droplet Large respiratory droplets
  • Room: Private room; curtain drawn; ≥3 ft separation
  • PPE: Surgical mask on entry. Patient wears mask during transport.
  • Examples: Influenza, pertussis, mumps, meningococcal disease, group A strep
Airborne Small particles that linger
  • Room: Airborne Infection Isolation Room (AIIR) - negative pressure, door closed
  • PPE: Fit-tested N95 or PAPR. Patient wears surgical mask during transport.
  • Examples: Tuberculosis, measles, varicella (chickenpox), disseminated zoster
Protective Neutropenic / reverse isolation
  • Room: Positive-pressure room with HEPA filtration
  • PPE: Strict hand hygiene; no fresh flowers or fresh fruit; restrict ill visitors
  • Examples: Severely immunocompromised, stem cell transplant, severe neutropenia

Combine multiple types when needed (e.g., SARS, measles + contact). When in doubt, ask Infection Prevention.

Don & Doff

Don PPE (put on in this order)

  1. Gown
  2. Mask
  3. Goggles
  4. Gloves

Doff PPE (take off in this order)

  1. Gloves
  2. Goggles
  3. Gown
  4. Mask

Use only articles required for each isolation level: Contact, Droplet, or Airborne. Perform hand hygiene before donning and after doffing each piece. Follow CDC Guidelines for Isolation Precautions.

R.A.I.N. & GHS

R.A.I.N.

  • RRecognize the presence of a hazard
  • AAvoid exposure through use of protection
  • IIsolate hazards by securing the area
  • NNotify appropriate higher-level person

GHS pictograms

  • Exploding Bomb - Explosion or reactivity hazards
  • Flame - Fire hazards
  • Flame Over Circle - Oxidizers
  • Gas Cylinder - Gases under pressure
  • Corrosion - Corrosive to metals, skin, eyes
  • Skull & Crossbones - Acute toxicity (fatal/toxic)
  • Health Hazard - Serious long-term health effects
  • Exclamation Mark - Less serious health effects / ozone
  • Environment - Aquatic toxicity
  • Biohazard - Infectious materials & organisms

Disclaimer

This badge buddy is an independent quick-reference accessory and is not an official hospital credential, ID, or policy document. Emergency code meanings may vary by facility. Always follow Larkin Hospital’s current emergency procedures, training, and official policies.