HSC IICU Collection Guide

This article contains collection information specific to the IICU 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 IICU

Workload Sharing for HSC_IICU

• IICU patients tend to have a long stay, which increases collection complexity
• There was a perception that the PatientFollow Project creates a risk of a disproportionate number of these admissions on the same laptop
• In order to avoid this, we set up a separate process that ensures the IICU admissions are always balanced between laptops.

Process

• A modified version of Using Cognos2 to keep track of patients is used
• Each new IICU patient will be on the CSS of all HSC laptops.
• A paper IICU census list is posted in the office with the collector name and laptop assigned to each patient.
  • Each of the 7 collectors will have at minimum one IICU patient assigned to their respective laptop. As there are 10 beds in IICU, the remaining three patients will be assigned on a rotational basis, as patients are discharged from the IICU and the assigned laptop. ie. each collector at varying times may have up to 2 IICU patients on their laptop.
  • The collector who picks up that admission uses Cognos2 Service Starter to enter the patient; subsequent service and unit changes will then show up as usual
  • On the HSC laptops that did not pick up that admission, the "exclude" button is used to omit the record from CSS
• This process has fluctuated with vacant positions and the actual number of collectors at HSC. ie. When there were five collectors at HSC, each collector had two IICU patients divided amongst the seven laptops.

implementation details

Cognos2_matcher query was updated to include all IICU patients, ie the filter based on site was preserved but the filter based on chart number ending omits them

Work Space

Work space in IICU is limited.

Collectors may use the small computer desk or one of the side desks used by nurses, if available.

• Rounds takes place in the morning, so the best time to work in IICU is in the afternoons.
• Collectors may take the large black binders (containing thinned charts and CCFS) to their office for review and to check TISS sheets, but make sure to let the CRN or the bedside nurse know. This was confirmed by the manager and CRN in IICU.

Coding in IICU

• For a typical IICU patient, use the following codes if applicable:
  • Respiratory failure (insufficiency), chronic in admit codes. (If the patient came from another unit (ex.MICU) this code would be an acquired diagnosis in that profile).
  • Code the underlying cause for the respiratory failure (ex. GBS, C-spine injury, etc).
  • Muscle, wasting/atrophy NOS
  • Tracheostomy, has one

Additional Info

All IICU patients are entered as "medical" under Admit Type for APACHE II, even if they are admitted from SICU.

Other HSC site specific info

see Category: Health Sciences Center Office