HSC Critical Care Collection Guide
See also:
- HSC General Collection Guide for information that applies to both HSC Medicine and HSC ICU Data collection.
- Medicine Curriculum for information that applies to Medicine Data Collection at all sites
- ICU Curriculum for information that applies to ICU Data Collection at all sites
- Category: Health Sciences Center Office for unit specific information, eg MICU
Workload balancing
See HSC ICU locations and serial number sharing.
We will use the Transfer_Tracker.mdb and EPR as much as possible to coordinate times.
Label forms
TISS and green sheets should be labelled a,b or d. Collectors need to be aware of which patient belongs to which collector to avoid missing patients.Go ahead and label other collectors patients on the day you are working.This avoids confusion about which patient belongs to which collector.
Admission times
See also Identifying ICU admissions
Collectors will make an effort to assess the accuracy of admission times ASAP so that those collectors that need to coordinate times from the sending unit can see the time on the transfer tracker.We will back up during the lunch break to try to make those times available.
Pharmacy
If patients are transferred to the wards the medication records may be in the nurses Mar binder or in a thinned chart. The ward clerks will help locate these thinned charts.
Labs
25% Albumin is often given and is often not on the intake and output sheet but will be found on the medication record. Cross reference the blood administration record.
Thinned Charts
This is a big problem at HSC. Patients are transferred to different areas often and the chart doesn't follow the patient in many cases. Notify the ward clerk of the unit the patient is located that part of the chart is missing. If it is still missing after the clerk has attempted to locate it then ask for the clerk to call medical records for any recent volumes. In some cases the chart has gone down to med records in error instead of following the patient. Patients transfered to RR5 get the whole chart sent to medical records to sorted and bound and then returned to that ward.If your patient gets transferred to RR5 you may have to wait until the bound volume returns.
TISS forms
Missing TISS forms
This appears to happen mainly in SICU. Collectors will try to make staff more aware of not sending the form to the wards. Trish has agreed to talk to the managers at one of the meetings.
Green Sheets
Green sheets are filled out fairly well at HSC. Collectors should always read them and enter data as necessary then place them in the confidental waste once the file is complete.The file should not be marked complete unless the collector has read to green sheet and entered any additional data.Green sheets should be labeled and the ones for discharged patients should be collected each day that the collector works.
Transfer times MICU/CCU/SICU/IICU
Collectors will make an effort to assess the accuracy of admission times ASAP so that those collectors that need to coordinate times from the sending unit can see the time on the Transfer Tracker.mdb. We will back up during the lunch break to try to make those times available. To determine transfer times the first set of vital signs is the guide. Medicine collectors at HSC can find the transfer time by looking at the first set of vital signs in MICU. Unless there is a clearly documented time elsewhere in the chart the ward transfer time is usually 10 minutes prior to first set of vitals. It is a rare occurrence that those vital signs are not done. Collectors do need to be careful as there can be many pages of flowsheets for one day.The old addendum sheets are not supposed to be used but I will also occasionally see an addendum sheet. The EPR can also be a guide but at HSC it isn't always accurate and in some cases the the time in the EPR is after the patient was clearly in the unit according to the vital signs record.
- Transfer Tracker.mdb is broken, so this must be done differently now. How? Ttenbergen 12:44, 2016 November 9 (CST)
Off-ward medicine locations
Make sure that patients admitted from off-ward locations for wards we collect are coded as admit-from the ward where we actually collect.
See OVER#HSC_over_wards for more information regarding which locations this applies to.
STB ACCU transfers
STB ACCU is used as a bed borrow sometimes post angio and then patients are sent to HSC CCU. The only way to tell if it was a bed borrow or not is to look for a nursing transfer record or check Transfer Tracker.mdb.
- Transfer Tracker.mdb is broken, so how is this done now? Ttenbergen 12:45, 2016 November 9 (CST)
SICU patients 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 use the overflow variable for SICU Pt in PACU.