HSC Critical Care Collection Guide

• HSC ICU collectors, please document collection data guidelines for related to HSC ICU units here. If there are any collection details that are specific to your ward, they should be documented here also.

This will serve as a reference for any collector who is assigned or choices to pick up extra hours during sick or vacation at this site.

If you want to see current guideline for sites go to: Medicine Curriculum or ICU Curriculum and look at top of this article to find link to hosp/unit specific guideline in progress.--Thanks everyone.TOstryzniuk 20:18, 21 October 2010 (CDT)

• ICU Curriculum

HSC MICU/CCU Collection Guide

• July 21.09 - HSC-MICU & CCU will now be on one collection device: (HSC_MICU). Serial number sequencing for MICU/CCU will now start at 25232 (using 1-50 of every group of 100)

HSC SICU Collection Guide

Discussion

• Template:Discussion - Joyce Peterson to enter information here.

• • Template:Discussion

  The SICU log/census book is kept at the South nursing station.  This is seen when first entering the unit.  The log is in a shelf next to the unit clerk.  The binder with the completed TISS Sheets and Record of Special Treatment and Test Sheets is in the same shelf. These sheets are a good source for admission and discharge dates and times that may not have been put in the log book.  Patients who were not entered in the log book may also show up there, especially after a weekend as they may have float clerks who will not know to do the entry.

  There is a desk space nest to the FAX machine which may be vacant for a workspace, but there is no electrical outlet available.  There is space at the North nursing station with a computer to access KEA and an electrical outlet.  Next to it is a ste of shelves holding papers, where extra TISS and geen sheets must be restocked by the data collecor.
   
  The numbering for SICU patients goes from 51-100, eg patient 14599 is followed by 14600 then 14651.

  The patient type is always surgical in SICU, is medical in IICU.  If there is an SICU patient overflow into MICU, they will be entered in SICU's numbering on its laptop but the data will be collected by the MICU data collector.  If an MICU is overflowed into SICU, SICU's collector will get a number from the MICU log and collect on that patient.

  If an SICU is overflowed into PACU, SICU follows them there.  The PACU staff do not complete TISS forms.

REG/ADL/VAR:

  The admission time for a patient admitted from PACU may not be entered accurately in the log book if they had to hold on to them due to lack of space.  The SICU physician will enter the admission to SICU on the order sheet and that is to be considered the time of admission.  Any extra time in PACU is then considered overflow into PACU.

  A patient may be listed in the log book as being admitted from HSC ER, but this must be checked since they may have originated from another hospital/nursing staion and just had passed through the HSC ER.

  SICU/IICU must have a 'transfer ready date/time' collected.  This should be in the doctors' orders.  If is is not there, it may be on the Green Sheet, or in the doctor's notes.  Patients who are transferred to another ICU (not including IICU), do not have a transfer ready date/time.

  Discharge date and time for a patient who is an organ donor is not the time of death, but when they leave SICU.
  
  All patient who suffer a cardiac arrest must have the BRR/XBR completed.  This is the cooling protocol.

  The Filter section is relevant if a patient is on Long-Term ventilation.

DIAGNOSES:

  If a patient is admitted from the OR, the first admit diagnosis must be a surgery.

  If the patient was a trauma who went to the OR, the diagnosis will be under Trauma -post-op, e.g. craniotomy to evacuate a traumatic SDH, will be 'Subdural hematoma-POST-OP - MVA'.

  If a patient has a diagnosis of septic shock, at present the Septic Shock Study requires that the Temp Studies must have a date and time for the first low bp and first antibiotic related to that septic episode.  This information may be in the charting from another hospital or ward flowsheets/vital sign sheets.

  APACHE:
  The APACHE score information is often initially on an ICU Addendum, or if the patient was in PACU, on the ICU flowsheet or the PACU flowsheet.  The informatioon for the Glascow Coma Scale may be obtained from the back of the ICU flowsheet or more accurately from the nurses' notes.  

  If a patient has a VAP, only the date and not the time needs to be entered.

  LABS:
  Cautiion needs to be used when collecting the blood products and volume expanders as staff do not always chart these in red.  The total should not include OR administrations.

  The only x-ray viewer in SICU is in the Diagnostics room near the entrance to the unit.

  PHARMACY:
  The Pharmacy section does not need to be completed and so can just be checked as Complete.

Jpeterson 14:24, 4 May 2011 (CDT)