Download Unit Profile - PICU

Unit Profile - PICU
Nurse Manager
Clinical Nurse
Supervisor
Clinical Nurse
Specialists
Educational Nurse
Coordinators & PICU
Nursing Leadership
Brief Description of
the Unit
Julie Juno
Bob Remenapp
936-8980 / Pager 7613
232-9220 / Pager 9771
Annette Scott
936-4470 / Pager 30700
Tonie Owens
232-9202 / Pager 5241
Karrie Martis - Day
232-9217/ Pager 30686
Rochelle Heidt (Interim-Night)
232-9217/ Pager 3540
Brenda Shaw – Level E
232-9218/ Pager 30689
The mission of the PICU is to provide quality patient and family-centered care
throughout the critical phase of hospitalization. Principals involved in our unit
mission are: Family Centered Care, respect for each child/family as a unique
entity, consistent and comprehensive care for each child and family,
multidisciplinary approach, uncompromising respect for all persons and
viewpoints, and integration of the growth and development process into care.
There are 30 monitored ICU beds, with age ranges from newborn to young adult.
Many services admit patients to the PICU including: Pediatric Critical Care Medicine
Service, General Surgery, including trauma, Neurosurgery, Orthopedic Surgery,
Otolaryngology, Plastic Surgery, Hematology/Oncology, BMT, Nephrology,
Transplant, Cardiothoracic (overflow) and others.
The PICU utilizes “state of the art” technology and interventions in the care of the
patients, including CRRT and ECMO.
Pediatric Critical Care Nursing is a specialty within nursing that deals specifically
with human responses to life-threatening problems. Critically ill patients are
Unit Profile - PICU
defined as those patients who are at high risk for actual or potential lifethreatening health problems. These patients are often highly vulnerable, unstable
and complex, thereby requiring intense, rapid response and vigilant nursing care.
The PICU nurse must be able to monitor and safeguard the quality of care that the
patient receives.
The PICU critical care nurse is responsible for ensuring that all critically ill
patients and their families receive optimal care. PICU nurses care for patients that
require complex assessments, high-intensity therapies and interventions, and
continuous nursing vigilance in a highly stressful environment. The PICU nurse
must be able to cue into subtle changes in the patient’s status that may require
multi-level assessment and intervention to prevent deterioration into life
threatening situations. The PICU nurse must be able to anticipate the child’s needs
and be sensitive to the child’s nonverbal communication. The PICU nurse must be
able to function in an environment that includes many stressors such as multiple
machines, variable noise levels, volumes of decisions, and ever-changing priorities
and demands.
Common Medications
In addition, the PICU nurse must be able to assess the patient and the family’s
coping mechanisms and provide/seek support as needed. The PICU nurse has a
responsibility to serve as the patient’s advocate and act as a liaison between the
patient, patient’s family and other healthcare professionals including Social Work
and Child Life.
See attached document
Unit Profile - PICU
(Categories of Drugs)
Common Patient
Procedures
Common Unit
Practices
Common Medical
Diagnoses
Placement of urinary, nasogastric and post-pyloric feeding tubes; Peripheral IV,
central venous and arterial lines; endotracheal intubation & extubation;
tracheostomies; respiratory support including chest physiotherapy & suctioning;
neurologic assessment including maintenance of intracranial pressure monitoring
systems; pain & sedation assessment & management; ECMO; CRRT; patient
transport for diagnostic and therapeutic procedures i.e. MRI, CT, angio, OR.
1. Rounding Standards – Rounds are conducted at the bedside by the physician
service with all members of the health care team including patient & parents.
Times vary according to service.
2. Communication Standards (i.e. SBARC) – although there are no required
communication standards such as SBARC in the PICU, professional
communication practices & behaviors are taught & expected & are consistent
with SBARC.
3. Shift to Shift Routines – the same level of care is required across all shifts; daily
hygiene and weights are generally performed between 7p-11p. Sleep Therapy
guidelines are practiced for patients whose care needs permit the limited
amount assessment within the guideline.
4. Process and Contacts for calling a Patient Care Conference – Family members,
Bedside RN’s, members of the Nursing Leadership or Physician teams may
identify the need for a patient care conference. Once the family, physicians or
nurses have identified the need, the Resident Assistant coordinates
date/time/location/invitees.
Pneumonia, respiratory failure, status asthmaticus, sepsis, multi-organ system
failure, liver failure, kidney failure, metabolic disorders, degenerative
neuromuscular, neurologic disorders & seizures, cancers, leukemias, care of bone
marrow transplant, kidney transplants, & liver transplants. Multiple trauma
Unit Profile - PICU
Common Precautions
and Safety Measures
including brain, intra thoracic and abdominal, and orthopedic, injuries.
1. Precautions: contact, droplet, protective & respiratory
2. Restraints
3. Protection of critical airway
4. Transportation off unit maintaining ICU monitoring
5. Patient & Family Support Rounds
6. Safe handling of cytotoxic substances
7. Seizure precautions