Israeli Nursing Procedures, Directives & Safety Protocols

Vocabulary flashcards summarizing the expanded clinical procedures, safety directives, and nursing responsibilities outlined in the lecture notes.

Routine Blood Test (nurse-performed)

Venous sampling—including home visits—excluding blood type & cross-match.

Fecal Disimpaction Contraindications

Do NOT perform on advanced colitis, ulcerative colitis, diverticulitis, rectal prolapse or anal disorders.

Semi-Automatic AED Use

Nurse may defibrillate with a semi-automatic device according to MOH protocol.

Central Line Removal Restriction

Implanted devices (Hickman, Port-a-Cath) must be removed by a physician only.

IV Push for Bio/Chem Warfare

Nurse may give IV bolus antidotes in mass-casualty exposure situations.

Nasogastric Tube to Unconscious Patient

Permitted without ETT/trach for feeding or drainage; follow aspiration precautions.

Vaginal Speculum Insertion (culture/PAP)

Not performed on pregnant women by certified nurses; monitor bleeding & infection.

Therapeutic Phlebotomy Site Limit

Blood removal for treatment purposes allowed only from upper extremities.

Blood Donation Phlebotomy

Nurse permitted to collect donor blood under approved guidelines.

Peripheral IV Insertion Limits

Upper extremities only; start 0.9 % NaCl; know infection, phlebitis, air embolism, etc.

Ventilator Disconnect for Suction

Pre-oxygenate 100 %; monitor resp & hemodynamics; watch for hypoxia/arrhythmia.

Blood Product Administration

Requires independent verification by TWO registered nurses.

Anti-D Injection Autonomy

Nurse may administer Anti-D without a physician’s order when indicated.

Nurse-Initiated OTC Drug

Allowed from director-approved list; must assess patient & document decision.

Central Line Blood Draw

Nurse authorized to withdraw blood via CVC under sterile technique.

Central Line Flush

Heparin or saline flushing permitted per protocol to maintain patency.

Peripheral IV Flush

Saline/heparin flush after medication or between infusions to keep vein open.

Epidural Medication Administration

After doctor’s first dose; nurse must know spine anatomy, assessments & complications.

Emergency Adrenaline Decision

Nurse may decide to inject epinephrine for anaphylaxis even in home setting.

Routine Vaccination Authority

Nurse empowered to order and administer standard immunizations.

Newborn Vit K & Eye Prophylaxis

Nurse may decide and give vitamin K IM and antibiotic eye drops to neonates.

Physical Restraint Decision

Nurse may apply/remove restraints to ensure safe care; reassess frequently.

Delegating Treatment to Caregiver

Nurse can grant personal permission for specific home procedures after training.

Tracheostomy Cannula Reinsertion

Life-saving replacement of dislodged trach tube allowed for trained nurse.

Chronic Rx Renewal

Nurse may re-issue physician-written prescriptions from approved chronic list.

ER X-Ray Referral

Nurse can order chest or skeletal x-ray in ER/ICU/urgent care/trauma settings.

Foley Catheter Insertion—Rehab

Decision authority for nurses in rehabilitation centers.

Foley Catheter Removal—Rehab

Rehabilitation nurse may decide to discontinue urinary catheter.

Post-Sedation Child Discharge (BERA)

Audiology nurse authorized to release child once criteria met.

Glucagon for Severe Hypoglycemia

Nurse may independently inject IM/SC glucagon in life-threatening low glucose.

Home Foley Replacement

Community nurse may insert/remove foley in patient’s home when indicated.

Amniocentesis Assistance

Nurse aspirates amniotic fluid under physician guidance during procedure.

First-/Second-Degree Wound Care

Nurse decides dressings & ointments for superficial burns/partial-thickness wounds.

Low-Flow Oxygen Therapy

Initiate or stop O₂ in conscious adult; reassess saturation & document.

Dialysis AV Access Needle

Nephrology nurse cannulates AV shunt/graft & gives meds during dialysis.

Endoscopic Procedure Assistance

Tasks include contrast injection, device activation, biopsy forceps handling, etc.

Psych Mechanical Restraint

Charge nurse may restrain/isolate psychiatric patient in 30-min increments.

Intrathecal Baclofen Refill

Nurse injects baclofen into implanted pump per physician order.

Bronchoscopy Nurse Duties

Instill lidocaine/NS/Hexakapron, operate forceps, insert laser/cryo/biopsy tools.

COVID Unit Special Procedures

Additional authorized tasks unique to designated coronavirus wards.

Orthopedic Skeletal X-Ray Referral

Inpatient/outpatient ortho nurse may order extremity imaging.

Stage 3–4 Wound Therapy

Community/home nurse uses advanced dressings for hard-to-heal ulcers.

Foley Insertion in Delivery Room

Maternity nurse may place catheter during labor management.

ECMO Manual Start

Certified nurse may power on ECMO in life-threatening event.

ECMO Emergency Shut-Off

Trained nurse can turn off ECMO to save life in critical malfunction.

NIHSS Assessment Authority

ER/Neuro nurse performs NIH Stroke Scale on suspected CVA patients.

Gastrostomy Tube Replacement

Trained nurse changes or removes established PEG in hospital/community.

Initiating Oral Feeding Post-Stroke

Rehab/Neuro/Geriatric nurse starts diet after swallowing assessment.

Pre-Op Stoma Site Marking

Enterostomal therapy nurse selects optimal abdominal ostomy location.

Blood Typing (No Cross-Match)

Community nurse may sample for ABO/Rh typing only.

Peripheral Nerve Block Injection

Inpatient nurse injects meds into established nerve block per order.

Nephrostomy Flush

Nurse irrigates nephrostomy tube with sterile solution per protocol.

Biliary Drain Flush

Authorized flushing of biliary catheter in all care settings.

Cystostomy Catheter Change

From second exchange onward, nurse may perform in ward or community.

Urinary Catheter Removal—Internal Medicine

IM ward nurses can discontinue indwelling catheter when criteria met.

Pain Directive 155/2019

Mandates age-appropriate pain assessment; moderate pain reassessed each shift; document location, intensity & treatment.

Legitimate Indwelling Catheter Indications

Includes GU surgery, strict I&O, acute retention, stage 3 wound, pelvic fracture, end-of-life request.

Standard Precautions (10/2010)

Universal infection-control measures: PPE, hand hygiene, injection safety.

PPE Donning Sequence

1 Gown 2 Mask 3 Goggles 4 Gloves; reverse order for removal with hand hygiene steps.

Five Moments for Hand Hygiene

Before touching patient; before aseptic task; after body fluid exposure; after touching patient; after touching surroundings.

High-Risk Medications (41/2013)

Drugs with higher potential for serious harm; require special labeling, double checks & precise infusion.

Nursing Assistant Role

Performs delegated basic care; vital signs, glucometer, samples, ADL help, always under registered nurse supervision.

Pressure Ulcer Prevention Directive (153/2019)

Nurse assesses risk within 12 h, develops prevention/treatment plan, ensures continuity and multidisciplinary referral.