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This article contains information specific to STB Critical Care Units, see the [[ICU Curriculum]] for general information.  
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. '''


''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 CCU 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


== Cardiac Type patients ==
=== Relevant articles specific to STB Critical Care patients ===
As of October 1, 2010 CCU collectors do not collect data on CCU pts that are located in MICU or ICCS.  Instead these pts are put as MICU or CICU location with cardiac type.  The MICU or CICU collector is responsible for these patients.  If the pt care is transferred to the MICU attending, the profile will be restarted and it will be a medical type, instead of cardiac type.  This is done by the MICU or CICU data collectors.     
* [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]
===Legacy cardiac info ===
* prior to October 1, 2010: MSICU and ICCS had CCU patients as CCU overflows. They would often be located in one of these areas if they require intubation and /or IABP. However, they were still attended by the CCU doctors and the CCU data collector entered them as a CCU patient.  They usually remained under CCU unless further multi system issues exist that the CCU attending wished to transfer the care to the ICU.  In this case the patient is discharged from CCU and admitted to the ICU and the ICU data collector then would start a profile and continue to follow this patient.  The respective [[TISS]] sheet followed the patient as they are moved between units if they continued to be a CCU pt.)  The overflow was marked in the variable 5 slot.


== Labs ==
== CCI/TISS ==
* [[Lab Collection Process]]
*cardiac MRI, echos and angiograms can be found in the CCI picklist
Remember to count cardiac MRI, echos and angiograms in the labs.
*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.


*With the [[EPR]] we do not count any labs or pharms until the patient is discharged from the unit, it is the last thing we do.--[[User: LKolesar|LKolesar]]
== Pharmacy ==
Pharmacy is completed after final review of the chart.


== Code STEMI ==
== Code STEMI ==
Some heart attack patients are admitted straight to the heart cath lab without being admitted to the. See '''[[STEMI]]''' for collection instructions for such patients.
Some heart attack patients go straight to the heart cath lab directly from EMS. See '''[[STEMI]]''' for collection instructions for such patients.


== Cardiac Care patients ==
== Cardiac Care patients ==
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.


== Patient origins and types ==
==STB Swing Beds==
Medical type patients are those under medical service and may have come from a medical ward or from ER or from outside of the hospital. The medical wards at STB include
*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.
* E5
*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.
* B5
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
* E6
* A6
The surgical type patients are those that are admitted directly from the OR, PARR or any surgical ward. The surgical wards in SBGH are: 
* CR4 cardiac surgery ward
* 2B day surg
* 4B gyne
* 4A surg
* 7AS
* 7AW.
 
When a pt is admitted from CR5 (CICU) this pt is deemed a surgical type (not cardiac).
 
== cost center ==
== cost center ==
Our cost number for supply ordering is 6766
Our cost number for supply ordering is 6766


== [[Outreach efforts]] ==
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}}


[[Category:St Boniface Hospital Office (Critical Care)]]
[[Category:St Boniface Hospital Office (Critical Care)]]
[[Category:Site Specific Collection Guide]]
[[Category:Site Specific Collection Guide]]
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