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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