NU2ICU V3 logoBuilding the Concepts

Before we start let’s look at environmental nursing safety BASICS in ICU

 

Below is the ICU safety net we must build for both us and our patient at the start of EVERY shift!

Patient – identified, handed over ISBAR including “issues” that need co-observing prior to commencement of care (ie Stoma, pupils, wounds), lines labeled – arterial etc

Self inflating Hand ventilation set and face mask (+/- PEEP valve) is connected or ready for use (gold standard equipment)

Alarms – set and correct generally 20% above and 10% below ordered targets (designed to save both you and the patient)

Oxygen – under bed or in portable trolley and at least 1/2 full (ready for emergency gas failure or transport)

Suction – works and a clean ‘yankeur’ style suction catheter attached (vomit / aspiration avoidance)

Plugs – all important equipment in RED (or blue UPS battery backup sockets if you have them) and switched on (how embarrassing if the power went off!)

Chart – fluids both in and out tallied and compared for balance, neurological exams, ventilation, sedation and routine  care  (if it isn’t charted it didn’t happen) IE mouth care, pressure area documented by previous staff.  If digital charting you are logged in and admission data checked against patient

Medications – frequency etc correct per today’s orders, ensure enough drugs available to last though your shift plus next 2 doses (administration mistakes are sadly very common)

Infusions – signed, correct, labelled, in date and enough for next 2 hours and next infusion ready –  PCA co-signed etc (make sure it matches the order and is “in date”)

Personal Protective Equipment – gloves, gowns, handwash, face shield, shoe covers, goggles – whatever combination is required for safe and appropriate care of your patient

Leadership and your team members – who is there to help, guide and support YOU

 

Image – https://www.statnews.com/2016/09/07/hospital-icu-modernize/

ONLY AFTER BUILDING YOUR SAFETY ZONE ARE YOU READY TO START

CONCEPTS

R.E.S.P.E.C.T.
FAST HUGS BID
Sedation
Respiratory
ABG
The completion of the ICU Chart
Mouth Care
Pressure Area Care
Save your back!
Time
Tell it like it is!

REFERENCES

Essentials of Critical  Care Nursing: a holistic approach 1st Edition 2013 by Patricia Gonce Morton, Dorrie K. Fontaine

AACN essentials of critical care 1st Edition 2007  by Marianne Chulay, Suzanne Burns

ACCCN’s critical care nursing 2nd Edition 2012 by Doug Elliott, Leanne Aitken and Wendy Chaboyer

Oh’s Intensive Care Manual 7th Edition 2014 by Andrew Bersten, Neil Soni

 

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