Download Critical Care Team Expectations

CriticalCareTeamExpectations
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Allpatientsrequireadailyprogressnote*
AllpatientsrequireanoteinWakeOnewhenaneventorsignificantchange
instatusoccurs
Availablechecklistsandprotocolsmustbeusedtoguidealldecisionsinthe
ICU
Adailygoalchecklistmustbecompletedforeverypatient,every
daywiththeassistanceofanurseintheICU
TheSCCQuickReferenceHandbookshouldbeusedtoguideallcare
decisionsintheICU
CompletetheAdmissiontoICUchecklistforallnewadmissions
CompletetheTransportchecklistforallpatientsleavingtheICU
TheAttending/ResidentSurgeonBriefingChecklistmustbecompleted
priortostartinganyoperationperformedbyaresidentsurgeon
Alwaysmaintainopenlinesofcommunicationwithallmembersof
healthcareteamintheICU
PriortotransferringapatientoutofICU,notifythecareteamthatwillbe
providingcaretothepatientaftertransfer
o AtransfernoteinWakeOnemustbecompletedpriortotransfer
*DailyICUProgressNote–
 Usetheprogressnoteentitle“WHAcuteSurgeryNote”
 Beforecreatingprogressnote,updatetheProblemList(seenextpagefor
criticaldiagnoses)
 ICUteamisresponsiblefornotesonallpatientsintheTICUorSICUatthe
timeofmorningcheckout/checkin(0600)
 Assignprogressnotestotheattendingphysicianscheduletoroundinthe
respectiveICUonthatday
CriticalDiagnoses–
 Foranydiagnosispresentonadmission,itisveryimportanttodesignateitas
suchbyclickingthe“Presentonadmission”buttoninthe“NewProblem”
window
 Everyoneofthefollowingdiagnosesthatareapplicableineachpatient
shouldbeincludedintheProblemListexactlyaswrittenbelow.Iftheexact
wordingisnotincludedautomaticallybyEPIC,changethewordingunder
“Display”inthe“NewProblem”window.
o SepticshockispresentifpthasSIRS+infection+hypotension
o Makesureacutebloodlossanemiaisspecifiedas“acute”
o Makesurethatprotein/caloriemalnutritionisdocumentedas“Severe
proteincaloriemalnutrition
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Acuterenalfailureduetoacutetubularnecrosis
Acuterenalfailure
Acuterenalfailureduetorenalcorticalnecrosis
Acuterenalfailureduetorenalmedullarynecrosis
Acutebloodlossanemia
Septicshock
Severeproteincaloriemalnutrition
Cerebral/vasogenicedema
Pneumonia
Acuterespiratoryinsufficiencyfollowingtraumaandsurgery
Sepsis
Septicemia
Severesepsis
Acidosis
Cardiacarrest
Braincompression/herniation
Acutemyocardialinfarction,initialepisodeofcare
(Nontraumatic)subarachnoidhemorrhage
(Nontraumatic)intracerebralhemorrhage
Acuterespiratoryfailure
Acuterespiratoryfailurefollowingtrauma
Cardiogenicshock
Hemorrhagicshock
Hypovolemicshock
Shockwithouttrauma
Traumaticshock
Postoperativeshock
Shock
ConcussionwithprolongedLOCwithoutreturntopre‐existinglevelof
consciousness
SubarachnoidhemorrhagefollowinginjurywithprolongedLOCwithout
returntopre‐existinglevel
IntracranialinjurywithprolongedLOCwithoutreturntopre‐existinglevelof
consciousness
SubduralhemorrhagefollowinginjurywithprolongedLOCwithoutreturnto
pre‐existinglevelofconsciousness
NontraumaticextraduralhemorrhageoNontraumaticsubduralhemorrhage
oDiabeticcomatype1(juveniletype)oDiabeticcomatype2
Klebsiellapneumonia
Pseudomonaspneumonia
H.Influenzapneumonia
Staphylococcuspneumonia
MRSApneumonia
E.Colipneumonia
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Gramnegativepneumonia
Aspirationpneumonia