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This article contains collection information specific to the SICU at HSC.
This article contains collection information specific to the [[HSC_SICU]].
''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 HSC 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 HSC in the program or unit level articles. ''


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* [[HSC General Collection Guide]]
* [[HSC General Collection Guide]]
* [[HSC Critical Care Collection Guide]]
* [[HSC Critical Care Collection Guide]]


== Ward contacts ==
== Ward contacts ==
see [[HSC SICU#Contacts]]
see [[HSC SICU#Contacts]]


== Log Book ==
The SICU log census book and the binder with completed TISS forms are kept at the South Nursing station.  The white test sheets are also kept in that binder, and they may be discarded in confidential waste after 5 days. Patients who were not entered into the log book may be found by looking at the TISS sheets and on EPR. All admissions in the binder are numbered with the 1-11 sequence to divide workload between the 3 ICU collectors. See [[HSC ICU locations and serial number sharing]].
== TISS sheets ==
As of February 4, 2020, SICU keeps TISS forms of patients still in the unit on a clip board at the front desk (same as MICU). Label these with SICA-SICB-SICD to help keep track and avoid any missing forms. If any are not on this clipboard, check the patient's bedside table, as some staff are still getting used to the new system of keeping TISS forms all together at the desk.
== Green Sheets ==
The [[Green sheets]] are in a binder on the Rounds Table, which is located in the side corridor to the left of the entrance into the unit.  Completed Green Sheets (of discharged patients) are kept on the inside front cover of this binder, and may be retrieved before the start of rounds at 9 am.
* At the North nursing station is an upright set of shelves which has a space for the TISS and Green sheets which the data collector keeps stocked.
* Thinned charts are kept on the high shelf at the front desk.


== Work Space ==
== Work Space ==
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* If not being used, the X-ray viewing room may also be used by collectors.
* If not being used, the X-ray viewing room may also be used by collectors.


==SICU patients in PACU==
* The admission time for a patient admitted from PACU may not be entered accurately in the log book if they have been held in PACU due to lack of space.  Always check to ensure the time used for the database is accurate.  The SICU physician will enter the admission to SICU on the order sheet and that is considered the time of admission. Any extra time in PACU is then considered bed borrow in PACU.


*For SICU patients coming from PACU we use the time they are accepted by SICU as the admit time. For SICU patients transferred to PACU who are waiting to be transferred elsewhere we use the time they leave PACU as the discharge time. In both cases we enter this as bed borrows in the temp file.
== Log Book ==
We no longer use the log book to track admissions in SICU See [[Using Cognos2 to keep track of patients]] instead.


== Transfer Ready Date ==
==SICU overflow in PACU==
SICU must have a 'transfer ready date/time; entered, unless they are transferring to another ICU bed (not including IICU). Transfer to IICU is treated like a transfer to a ward, but the data collection once there is treated like an ICU patient.
SICU patients often overflow into PACU, which is captured in the tmp file using [[Boarding Loc]].
*For admissions from PACU, use the time they are '''accepted by SICU''' as the admit time. The SICU physician will enter the admission to SICU on the order sheet or it is sometimes charted in the PACU Record by the nurse. TISS starts when the patient is accepted by SICU.
**The SICU log book may not reflect the accurate time of admission from PACU. Always check the chart to ensure the '''accepted by SICU''' date/time is used.
*For transfers to PACU who wait for transfer elsewhere, use the time they leave PACU as the discharge time.
*For patients who are temporarily moved to PACU during their admission, and then return back to SICU, use the [[Boarding Loc]] tmp file to capture all the moves.
**Make sure to check the SICU log book, as these patients are often written in there as a second admission, when in fact this is a bed borrow scenario.
*Occasionally a code blue patient from a ward is admitted to PACU under SICU or MICU service, due to lack of beds in either unit.
**The [[Previous Location]] should be the ward that the patient came from.
**[[Service Location]] should be either HSC_CC
**Ensure that the appropriate [[Boarding Loc]] information is entered, as this is also an example of a bed borrow in PACU.


The preferred source for the Transfer Ready date and time is the Green Sheet. If that is blank, the next source is the doctors' order sheet.
== Rounds ==
Rounds start at 09:00, so charts may not be available at that time. On Wednesdays Rounds start an hour or 2 later.


== Overflow ==
{{Discuss | Is the following consistent with [[ICUotherService]] and how we do it now? Ttenbergen 16:55, 2020 April 9 (CDT)}}


If a patient '''overflows into another unit''', it is still called by its home unit in the location, and the number must be taken from the home unit log. The data is collected by the collector where the patient resides and put onto the home unit database.  Return to the home unit is not a transfer.
== APACHE ==
See [[Apache II General Collection Guidelines]]


If a patient is '''overflowed into PACU''', SICU follows them there. The PACU staff do not complete TISS sheets and transfers out may not get into the log book so must be followed up by the Data Collector.
These numbers are collected from the SICU CCFS.


== Rounds ==
GCS data is obtained from the IPN, or from the Neurological Assessment Record.
Rounds start at 09:00 so the chart may not be available at that time. On Wednesdays Rounds start an hour or 2 later.
*The best source for the GCS is the admitting RN's notes. Patients are often initially sedated and this is shortly DC'd, which then allows a proper assessment and GCS data. 
*The neuro patients or head trauma patients may be sedated for long periods of time and the admission GCS may need to be used. Those patients will generally have a very poor neuro status even without sedation. 
If the patient comes from PACU, use the PACU Vital Sign Record, from the time the patient was accepted by SICU service.


== APACHE ==
For [[Admit Type for APACHE II]], the surgery must be an E1 to qualify as Emergent, otherwise enter Elective.
*These numbers are collected from the ICU Addendum Sheet/s and the flowsheets. If the patient comes from PACU, they do not use the ICU Addendum sheets.  Under [[Admit Type for APACHE II]], the surgery must be an E1 to qualify as Emergent. This info is found on the white typed OR sheet which indicated the start and end times, procedure, etc. (Not the Anesthetic Record).
*This info is found on the OR Record.


*The best source for the GCS is the admitting RN's notes.  Patients are often initally on Propofol and this is shortly DC'd which then allows a proper assessment.  The neuro patients or head trauma patients may be sedated for long periods of time and the admission GCS may need to be used.  Those patients will generally have a very poor neuro status even without Propofol. 


== Clipboards ==
== Clipboards ==
These are kept at each bedside and have  
These are kept at each bedside and have:
* the current Flowsheet  
*the current Flowsheet  
* possibly the Flowsheet for the day before for reference during Rounds
*possibly the Flowsheet for the day before for reference during Rounds
* the MARs
*the MARs
 


== Charts ==
== Charts ==
The charts are kept at each bedside. Lab sheets are usually in the chart.
The current charts are kept at each bedside. Lab sheets are usually in the chart.
 
Thinned charts and old charts are kept on the high shelf at the front desk.
 
SICU does '''not''' save charts of patients who where discharged home or transferred to another facility for data collectors. They must be requested from MR. See [[HSC Medical Records requests]].
 
Charts of deceased patients are '''not''' kept in the Unit for data collectors. As is true for all deceased patients' charts, they are at the [[HSC Death Registry]].
 
 
== CCFS ==
The flow sheets contain various data points that we collect, but they are not always complete. They must be used in conjunction with the chart to ensure that data is not missed. Some of the information found in the CCFS includes:
 
*VS (first vitals = arrive time)
*Medication infusions (these must be confirmed with MAR Sheets)
*IV medications, including regularly scheduled and STAT (these must be confirmed with MAR Sheets)
*Daily fluid intake
*Blood products (must be confirmed with the Blood Administration Record)
*Dressing changes (also check IPN)
*CAM
*Respiratory information, including modes of ventilation, presence of ETT/trach, extubations, etc.
*Various interventions including ICP, drainage tubes, lines, TF, TPN, HD, CRRT, CT's, MRI's, EEG, ECHO, scopes, etc.


Thinned charts and old charts are kept above the desk by the FAX machine at the South Desk.


Charts of deceased patients are not kept in the Unit for the Data Collector. As is true for all deceased patients' charts, they are at the [[HSC Death Registry]].
== Additional Info ==
A white board by the front desk lists the patients. It also lists:
*patients on the transfer list
*MICU patients borrowing a bed in SICU
*SICU patients borrowing a bed in PACU
*other valuable info


== Flowsheet s==
*The infusion drugs are listed under the vital signs and not on the MAR's.  The IV med's given are listed on the Fluid Balance section of the Flowsheet, as wellas any colloid.  The colloids should be in red, but are not always.  The number of the unit may be listed, but not the type, e.g. FFP vs PRB.  This may require checking the Blood Admin record for clarification.


== Other HSC site specific info ==  
== Other HSC site specific info ==  
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{{Related Articles}}
{{Related Articles}}


[[Category: Health Sciences Center Office]]
[[Category:Health Sciences Center Office]]
[[Category: Site Specific Collection Guide]]
[[Category:Site Specific Collection Guide]]
[[Category: Data Collection Guide]]
[[Category:Data Collection Guide]]
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