What supplies do we carry over?

Scott Van Allen from Materials Management has printed me a "par inventory worksheet" to determine par levels for our new unit.  I wanted to get everyone's opinion on a few items.  Does anyone use the blood tubing to the left with the chamber with the little white ball in it?  I'm pretty sure we only use the standard blood tubing for all blood products.  And the iv kit on the right to start an iv?  Also, what are you thoughts regarding bili-masks?  Do we need both kinds?  I personally like the white wrap-around ones.  Again, I need feedback on this one.

Flow of NICU Admissions

I apologize for my lack of computer graphic-ing abilities?!  From what we have discussed in meetings, here's a starting point, as is the "NICU Admission" post.  Please share your thoughts.

NICU Admissions

• A Resource RN will be assigned each shift to the 2^nd floor, if staffing permits.
• If "new admit" is able to be assumed into existing assignment, Resource RN, Delivery RN, and/or Charge RN will aid in completing the admission process with the Bedside RN with open, existing assignment.
• If "new admit" will not be able to be assumed into existing assignment, Resource RN will admit patient into a vacant room, or into the "micropreemie/high acuity" neighborhood if criteria met, and continue patient care for remainder of shift.
• Resource RN duties may be assumed as follows, if needed to continue patient care of two admitted patients.
  

Resource Order:

1. 2^nd floor Resource RN
2. Delivery RN (3^rd floor Charge RN to attend deliveries)
3. 3^rd floor Charge RN (2^nd floor Charge RN to attend deliveries and charge duties of both floors )
   
    

• If "new admit" fits criteria for admission into "micropreemie/high acuity" neighborhood, placement in that neighborhood must be assured. Stable, existing occupants, not meeting "micropreemie/high acuity" criteria, will be transferred out, to meet placement/staffing needs. SBAR, OBTraceVue, and open communication between NICU/LDR/HROB will facilitate proper "micropreemie/high acuity" placement.
• Resource RN will facilitate admissions, until patient assignment is assumed.

Absorbing Assignments:

1. Resource RN
2. Delivery RN
3. 3^rd floor Charge RN
4. Bedside RN, if becomes available (i.e. discharges)

  

        

SJWH-NICU Wayfinding

In early May, I had an opportunity to meet with Carmen Zeno from our Security department.  Unsure of what additional support her department would be able to offer us, I devised the following plan to secure our unit.  Please share your thoughts.

SJWH-NICU Wayfinding

2^nd and 3^rd floor elevators will open to a secured vestibule.  Entrance into NICU through either floor will be dependent on the following steps:

1. Visitors will pick up phone located in vestibule that rings directly to HUC/Reception Desk
2. HUC/Charge RN will answer phone and request patient identification (Baby’s last name)
3. HUC/Charge RN will instruct caller to wait briefly, that someone will be there shortly to allow them in
4. HUC/Charge RN will notify PCT/PST/RN “greeter” of visitor and patient identification, then send a message via nurse-call to notify the bedside nurse of upcoming visitors
5. “Greeter” will have a list with all patient’s names, ID band numbers, and room # (this list may have 3 boxes next to each patient, to track 3 visitor limit)

Patient	Band #	Room #	Band Holder	Visitor 1	Visitor 2
Smith, Boy-Lisa	12345 BTE	2101

6. “Greeter” will open secured unit entrance and verify band holder’s band, then allow the entrance of a maximum of 3 visitors (band holder plus 2)
7. Checks will be entered in the boxes to account for number of visitors
8. Visitors will be directed towards the patient’s room
9. Bedside RN will have received notification via nurse call
10. If “Greeter” receives notice of visitors for a “visitor-occupied” room, “greeter” would contact the bedside RN or go to patient room him/herself to inform band holder of secondary visitors
11.  Band holder would then select to exchange visitors, or allow secondary visitors to continue waiting
12. “Greeter” will either:
1. monitor visitor exchange (assuring there will be at least one band holder in patient room during any visitation, and maximum of 3 visitors per room)
2. inform secondary visitors of existing visitor capacity, and that they will be able to exchange shortly

Let's get the ball rolling...

Today we met with Ideacom, the vendor for our West-Call nurse call system.  This was their second demo on the system.  NICU had the first hour, Mom/Baby, Imaging, and Gyn had the second hour.  Each nicu patient room will have two wall stations.



Red Staff Emergency button will notify the Nurse and RT assigned to the room, as well as the Charge Nurse on that floor.  This could take the place of our current "RESPIRATORY" call.
Code Blue Button will notify the 2nd floor Charge Nurse, Delivery Nurse, Float RT, Floor RT, and the Neo or NNP.



Red and Blue buttons will elicit the same responses as the unit above.  The Green Button will alarm at the front desk.  Anyone who answers that green "nurse call" button call will be able to speak into the room via the speaker.  Currently, the thought is to avoid speaking through that wall speaker, which is located right behind the baby's giraffe, and would add unnecessary noise.  The outlet on the left, under the red button, is where the vents plug into, alarming us of vent disconnect or malfunctions.  The outlet on the right, under the blue button is where the pillow speaker plugs into.  Currently, the thought is to solely use the pillow speaker as a remote control for the tv. 

 



This is the master station that will be housed at the HUC/Reception desk.  Assignments will be entered at this unit, linking the caregivers, with phones and badge locators.  These assignments may be entered up to 4 hours before shift change.  AHCA requires that these are manned at all times, therefore, the HUC may not step away without being relieved.

Good night all!  I'll post more tomorrow, when my eyes aren't rolling backwards :) Monica