HSC SICU Collection Guide

This article contains collection information specific to the SICU at HSC. 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.

See the following for more general information:

• HSC General Collection Guide
• HSC Critical Care Collection Guide

Ward contacts

see HSC SICU#Contacts

Work Space

• There is a desk space next to the FAX machine at the South desk that may be vacant for a workspace, but there is no electrical outlet available and it is often used by the CRNs.
• There is a larger space at the North Nursing Station which may be free. There are electrical outlets there.
• If not being used, the X-ray viewing room may also be used by collectors.

Log Book

• The SICU log census book is kept at the South Nursing station.
• 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.
• If any admissions are missed, collectors can find them by checking the TISS forms and EPR, and add them in the log book.

TISS sheets

See TISS General Info

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.

The binder with completed TISS forms is kept at the South Nursing station as well. (The white test sheets are also kept in that binder, and they may be discarded in confidential waste after 5 days).

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.

SICU overflow in PACU

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.

Transfer Ready Date

• 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. See Transfer Ready DtTm field

• The preferred source for the Transfer Ready date and time is the order sheet, and for IICU it is the date/time on the Consult 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.

APACHE

See Apache II General Collection Guidelines

These numbers are collected from the SICU CCFS.

GCS data is obtained from the IPN, or from the Neurological Assessment Record.

• 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.

For Admit Type for APACHE II, the surgery must be an E1 to qualify as Emergent, otherwise enter Elective.

• This info is found on the OR Record.

Clipboards

These are kept at each bedside and have:

• the current Flowsheet
• possibly the Flowsheet for the day before for reference during Rounds
• the MARs

Charts

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.

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

Other HSC site specific info

see Category: Health Sciences Center Office

Related articles

Related articles:

HSC Critical Care Collection Guide (← links)