HSC MICU Collection Guide: Difference between revisions

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== Log Book ==
== Log Book ==
*There is a black log book for all MICU patients (kept at the front desk). Do not change the numbers as the unit keeps their own data on patients and the numbers collectors use are different.  
*There is a black log book for all MICU patients (kept at the front desk). Do not change the numbers as the unit keeps their own data on patients and the numbers collectors use are different.  
*The admissions in this log book are numbered by collectors with the 1-11 sequence to divide the workload. See [[HSC ICU locations and serial number sharing]].  
*The admissions in this log book are numbered by collectors with the 1-11 sequence to divide the workload. See [[HSC ICU workload splitting]].  
*If any admissions are missed, collectors can find them by checking the TISS forms and EPR, and add them in the log book.
*If any admissions are missed, collectors can find them by checking the TISS forms and EPR, and add them in the log book.
*Collectors sign off their patient admissions in the log book, by putting their serial number and initials on the left-hand side of the page.
*Collectors sign off their patient admissions in the log book, by putting their serial number and initials on the left-hand side of the page.

Revision as of 10:48, 2020 June 5

This article contains collection information specific to the MICU 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:

Ward contacts

see HSC_MICU#Contacts

see HSC MICU

Work Space

Collectors can find a space to work in the nook behind the main desk, between cubicle 1 and 2.

The unit is divided into 2 sections:

  • front: beds 1-10
  • back: beds 11-20


Log Book

  • There is a black log book for all MICU patients (kept at the front desk). Do not change the numbers as the unit keeps their own data on patients and the numbers collectors use are different.
  • The admissions in this log book are numbered by collectors with the 1-11 sequence to divide the workload. See HSC ICU workload splitting.
  • If any admissions are missed, collectors can find them by checking the TISS forms and EPR, and add them in the log book.
  • Collectors sign off their patient admissions in the log book, by putting their serial number and initials on the left-hand side of the page.
      • Due to the COVID outbreak, we are now printing out an MICU Admission Register and Transfer Register from EPR Reports and dividing the patients the same way, but in our office.


TISS Sheets

See TISS General Info

The TISS sheets of patients still in the unit are on a clipboard at the front and back desk.

  • Label these with MICA-MICB-MICD, to help keep track and avoid any missing forms.

The completed TISS sheets and Green sheets are kept in a white binder at each desk. White test information sheets are kept for 5 days and then the collectors can discard them into confidential waste.


Green Sheets

The Green sheets for patients currently in the unit are kept on the rounds table. The clerks stamp them for all new patients, but occasionally one gets missed.

After your pt file is complete the Green sheets can be discarded into confidential waste. We no longer hand these in to the main office.

The ward clerks will order the TISS and Green sheets if you ask them. Monitor to see if they are getting low. Contact p:Pagasa Torres in advance before stock is low and she sends order to print shop. (there is a 1 week turn around time). We do keep stock in main office so that if units need, turn around time can be quicker.

  • I have spoken to the clerks in MICU and they do order their own TISS forms and Green sheets. Is it not possible to have SICU and IICU order their own as well? --Jvelasco 11:57, 2020 February 28 (CST)
    • will check this out with Pagasa and printshop. If we made changes to the form then unit would not get most current. Trish Ostryzniuk 14:44, 2020 February 28 (CST)
    • Which Cost Center they are charging to?
      • I do not know. --Jvelasco 15:14, 2020 April 7 (CDT)
  • SMW


  • Cargo


  • Categories

Another question: Since we are not to go to the units during the COVID outbreak, how do we supply the ICU's with TISSs and Green sheets? For sure SICU and IICU will need to be restocked. MICU seems to restock their own according to the ward clerks, but that does not seem to be verified so far...--Jvelasco 15:14, 2020 April 7 (CDT)

  • when was the last time you request TISS form for SICU or IICU guys? Pagasa say HSC has not requested any for long time since Oct 2019 actually. Trish Ostryzniuk 17:19, 2020 April 15 (CDT)
    • We do not request TISS forms/Green sheets for SICU or IICU. We go to your office and Pagasa gives us a stack of both. Or we email Pagasa when the supply is running low in our office, she brings them here and we then deliver some to both units. --Jvelasco 13:26, 2020 April 17 (CDT)
  • SMW


  • Cargo


  • Categories


Overflows

See Boarding Loc

MICU is a closed unit, which means that only the MICU service is looking after the patients.

  • All files are entered using HSC_MIC service location.

Due to the COVID-19 outbreak, some SICU patients are now being treated in MICU, until they are proven to be negative. See COVID-19 (SARS-COV-2)under Cohorting in HSC ICUs.

  • If they are under MICU service, enter them using HSC_MIC service location, and add SICU under MICU in the tmp file. See ICUotherService.
    • Once they are transferred to SICU, make a new file with HSC_SIC service location.
  • If for some reason the patient is in MICU under SICU service, enter them using HSC_SIC service location and treat it as a Boarding Loc.
    • Make sure the TISS is labelled as SICU in this scenario.


Transfer Ready Date

  • MICU 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.


APACHE

See Apache II General Collection Guidelines

These numbers are collected from the MICU 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.

For Admit Type for APACHE II, enter Medical.


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
  • Lab sheet


Charts

The current charts are kept at each bedside.

Thinned charts and old charts are kept on wire racks at both desks.

MICU saves charts of patients who where discharged home or transferred to another facility for data collectors. They are kept in the black bins at the front and back desks.

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
  • other valuable info


Other HSC site specific info

see Category: Health Sciences Center Office

Related articles

Related articles: