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Surgical Intensive Care Unit
Scope of Service Overview:
Types and Ages of Patients Served:
The primary patient population include but are not exclusive to patients age 16 or older who sustain single or multi-system traumatic injury presenting in critical or intermediate care stages, neurological and neurosurgical patients that require critical or intermediate care, burn injury patients requiring critical and intermediate care and the surgical patient requiring critical care. Patient diagnoses may fall within ICD-9 diagnostic category range of abdominal, pelvic, extremity, orthopedic, and soft tissue injuries as well as any surgical procedure requiring critical care monitoring. Internal and External Customers: Internal customers served include other nursing units, physicians, patients, families, and all ancillary departments of the hospital. External customers we serve include, but are not limited to: home health care services, area nursing homes, area rehabilitation facilities, medical supply companies, other contracted medical service companies, outlying hospitals, and the local community. Conditions and Diagnosis Treated: The primary patient population include but are not exclusive to patients age 16 or older who sustain single or multi-system traumatic injury presenting in critical or intermediate care stages, neurological and neurosurgical patients that require critical or intermediate care, burn injury patients requiring critical and intermediate care and the surgical patient requiring critical care. Patient diagnoses may fall within ICD-9 diagnostic category range of abdominal, pelvic, extremity, orthopedic, and soft tissue injuries as well as any surgical procedure requiring critical care monitoring. Types of Services and Care Provided: The unit is jointly managed by a Medical Director, Nursing Director and a Nurse Manager. The Trauma Surgery Services and Associates provide the unit with physician care 24 hours a day. Surgical and Medical sub-specialties are available for consultation. (Neuro Intensivist/Medical Intensivist service is also available for designated patients.) Nursing staff includes the Director (RN), Nurse Manager (RN), Unit Coordinators, Trauma Program Manager, Clinical Nurse Specialist, Clinical Education Instructor, RN Case Managers, staff Registered Nurses (RNs), student nurse externs, patient care assistants (PCA), Universal Service Assistants (USA) and Unit Clerks. The RN staff provides the primary level of patient care and is responsible for regular observation and implementation of patient care plans and treatments. PCA’s provide basic patient care duties directed by the RN. The unit is staffed in nurse-to-patient ratios of 1:1, 1:2 for critical, 1:2, 1:3 for intermediates and 1:4 for stable observation/floor status patients. Nurses are trained in critical care with emphasis on trauma, neurological, and thermal injuries, and the use and maintenance of monitoring equipment. Collaborative practice is provided by a team approach of physicians, nurses, pharmacists, dieticians, social workers, respiratory therapists, and occupational, physical, case managers and speech therapists. A chaplain is also available on a daily basis. Sites Where Services and Care is Provided: Physically, the unit is comprised of 20 private rooms, 6 of which are negative pressure rooms. There are also 4 rooms with overhead heating panels for thermo regulation and Tub room. All rooms have bedside monitors with central and bedside displays. Each monitor has an electrocardiogram and four channels of pressure available. Identical patient headwalls have oxygen (one for compressed air) and vacuum outlets. All beds have emergency back-up power. Individual call lights with emergency notification are present at each bedside. Other equipment includes ventilators, volume pumps to control IV fluids, hypothermia blankets, EEG machines, crash cart and defibrillators, pneumatic TEDS, pulse oximeters, dynamaps, cardiac output machines, blood warmers and pumps, internal and external cooling devices, intracranial pressure monitoring, portable cardiac monitors and continuous temperature monitors. Most diagnostic services are provided at the bedside. They may include blood draws, x-ray, endoscopy procedures, metabolic cart, fluoroscopy, and bronchoscopy. For other tests, such as CT, MRI, invasive radiologic exams, patients are transported to the Radiology Department. Nursing staff and various multidisciplinary team members as appropriate escort the patients. Other treatments and procedures performed at the bedside include, but are not limited to:
Most diagnostic services can be provided on the unit including x-rays, ultrasound's, EKG, EEG, and laboratory tests. Patients requiring CT and MRI's leave the unit for the test. Monitored patients are transported by the nursing staff to other departments. Other bedside procedures may include peripheral IV insertion, care of central and arterial lines, chest tube insertion, intubation and percutaneous catheter insertions, and CVVH(D), suturing and tracheostomy. The Unit has also developed a follow-up program to provide continuity of care and a screening program for drug and alcohol usage and offers referrals (voluntary) to local agencies. Times When Services & Care is Provided: Care is provided 24 hours a day, 7 days a week, including holidays. |
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