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STB Critical Care Collection Guide: Difference between revisions

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This article contains information specific to STB Critical Care Units.  
This article contains information specific to STB Critical Care Units. '''Please make sure you document information at the most general level that is applicable, i.e. don't code something that affects all collection at StB in the program or unit level articles. '''
*See '''[[STB General Collection Guide]]''' for general STB information such as: links to EPR, Mail room, medical records. Information also in regards to obtaining hand sanitizer, wipes, printer paper for collection offices.
*See '''[[ICU Curriculum]]''' for general critical care info.


''Please make sure you document information at the most general level that is applicable, i.e. don't code something that affects all collection at StB in the program or unit level articles. ''
* See '''[[STB General Collection Guide]]''' for general STB information such as: links to EPR, Mail room, medical records. Information also in regards to obtaining hand sanitizer, wipes, printer paper for collection offices.
* See '''[[ICU Curriculum]]''' for general critical care info.
* Unit/Service Specific info:
** [[STB ACCU Collection Guide]]
** [[STB CICU Collection Guide]]
** [[STB MICU Collection Guide]]


See also:
=== Checklist for bedside data collection in STB ICUs ===
*[[STB ACCU Collection Guide]]
Due to incomplete implementation of the [[STB Electronic Patient Record]] some data is not yet available electronically and must be collected on the units. '''If this list changes, review [[STB Electronic Patient Record#Implementation Status]] and make sure they are consistent. '''
*[[STB CICU Collection Guide]]
*There is a specific list of items to obtain from the paper chart, the rest is obtained from EPR. 
*[[STB MICU Collection Guide]]  
* The bedside checklist is (Some of these only apply to some ICUs):
**Time and date of admission from flow sheet (the EPR time is not always correct)
**Apache vital signs, GCS, ARF urine and elective vs emergent surgery.
**Infusion drugs from flowsheets
**CCI items that may be immediately evident like IABP, ECMO, Impella/VAD, swan ganz, scopes, return to OR for bleeding, etc.
**Acquired complications that are immediately evident and get the date. ie. bleeding, shock, cva, arrhythmias, etc. 
**Review all blood product sheets and mark which products were given in the OR (these are not counted in our CCI).  The rest of the blood products are counted and once put into CCI, please put a pencil mark to indicate which have been counted. 
**Pre-CPB echo results can be found in the EPR.   
**[[Project ABO TEE]]: Get blood type from blood product information on chart


=== IMPORTANT INFORMATION DURING COVID PANDEMIC ===
=== Relevant articles specific to STB Critical Care patients ===
'' see [[STB General Collection Guide#IMPORTANT UPDATE DURING CORONAVIRUS PANDEMIC]] for general info
* [https://extranet.manitoba-ehealth.ca/hospitals/SBH/ICMSR/_layouts/15/start.aspx#/SitePages/Home.aspx STB Critical Care has a resource website maintained by our ICU Educators]
*STB ICU Data Collectors will be working from home until recalled or redeployed; we are monitoring our emails


=== Covid Unit info === <!-- pls leave that header in, it's so we can link this from [[COVID Designated Ward]] -->
== CCI/TISS ==
====AS OF NOVEMBER 2020, in order to accommodate COVID ICU patients & in an attempt to keep specific units "clean/dirty"====
*cardiac MRI, echos and angiograms can be found in the CCI picklist
“ACCU has transferred 4 of their beds over to ICCS, in order to take in 4 beds for ICMS overflow patients.  There has been a surge in ICU bed requirements lately, and this is part of the pandemic plan through HICS. 
*With the [[STB Electronic Patient Record]] we collect/count CCI/TISS entries as we are able when we review the record.  Confirmation of entries is done on final review of the chart.   
In order to keep ICCS somewhat green, ACCU will take on the overflow for ICMS. 
The ACCU attendings will be the responsible physicians for those patients in ICCS (this is different than the current guidelines, as these patients are not our overflow but part of their baseline);
The unit staff remain in their own units at this time  - collaboration between the units will continue, and conversations about acuity will be front and center.”
**ICMS has now 18 opened beds (14+4 in ACCU)
**ACCU remains 8 opened bed (4 main unit +4 ICCS)  giving their other 4 Bed to ICMS
**ICCS reduced from 14 to whatever available (e.g. 10)


=== On-site presence of collectors ===
== Pharmacy ==
*each ICU collector will be on site once weekly to collect completed TISS forms & complete profiles in Health Records & ICUs as required
Pharmacy is completed after final review of the chart.
**Valerie Penner will be on site each Wednesday
**Stephanie Cortilet will be on site each Thursday
 
=== [[STB Medical Records requests]] ===
 
== Cardiac Type patients ==
see [[STB Cardiac Care patients]]
 
== VAP notification ==
an email notifying that there is a patient who has met VAP criteria is sent by the Data Collector to the Chair & Co-chair of the VAP Committee, as well as to Rob Ariano, from Pharmacy.  Any further VAP notification will then be sent out by them. 
*positions of Chair & Co-chair are currently being filled by Christina Kuttnig & Carlos Molina respectively
 
See [[STB VAP Committee]].
 
== Labs ==
* [[Lab Collection Process]]
Remember to count cardiac MRI, echos and angiograms in the labs.
 
*With the [[STB Electronic Patient Record]] we do not count most labs or pharms until the patient is discharged from the unit, it is the last thing we do.--[[User: LKolesar|LKolesar]]


== Code STEMI ==
== Code STEMI ==
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See [[STB Cardiac Care patients]] for information specific to the cardiac service care patients in the STB MICU/SICU unit.
See [[STB Cardiac Care patients]] for information specific to the cardiac service care patients in the STB MICU/SICU unit.


==STB Swing Beds==
*STB Swing Bed entries are "bed" records within a "unit" in EPR/Cognos. They are not beds or locations but conceptual service location and time entries used for patient moves. This data causes a patient record to show up in Cognos/CUS as having arrived on a unit even when the pt has not actually arrived, and it isn't visible in our listings whether the record is for a swing or real bed.
*Any ICU pt. may be placed into a swing bed, but the majority of swing beds are used for the ICCS pt's. The pt. is placed in a swing bed while in the OR, and then moved into a real bed post op when they arrive in the CICU. Their stay in a swing bed may be any length of time. The true arrive Dt/Tm is taken from the ICU flow sheets.
if a pt. was placed into an ICU swing bed but was never admitted to the ICU, the pt. entries are manually excluded from Cognos when reviewed
== cost center ==
== cost center ==
Our cost number for supply ordering is 6766
Our cost number for supply ordering is 6766


== [[Outreach efforts]] ==
== [[Outreach efforts]] ==
St Boniface critical care collectors attend the [[STB VAP Committee]].
St Boniface critical care collectors attend the [[STB VAP Committee]] when requested by the chair/co-chair. There is no longer any need to email the committee regarding a potential or confirmed VAP


== Related articles ==  
== Related articles ==  
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