1 / 11

The PICU 2.0

The PICU 2.0. Goals. Improve resident experience in the PICU by improving consistency Reduce redundant information presented on rounds Include nursing input in a formalized fashion Improve resident ability and opportunity to formulate problem lists and plans Go LIVE October 18 th !.

matia
Télécharger la présentation

The PICU 2.0

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The PICU 2.0

  2. Goals • Improve resident experience in the PICU by improving consistency • Reduce redundant information presented on rounds • Include nursing input in a formalized fashion • Improve resident ability and opportunity to formulate problem lists and plans • Go LIVE October 18th!

  3. ExpectationsResidents • You know all of the patients in the unit • Stay involved on rounds on everyone’s patients • See all of the sicker patients first- prioritize order of seeing patients and acting on needs • Check and write orders on the “non-urgent” pad every 1-2 hours (if possible)

  4. ExpectationsNurses • Present for rounds on their patients • Ask for the orders they need during rounds • Use the non-urgent pad • Ask questions of the backup attending during rounds

  5. ExpectationsAttendings • Discuss our expectations and requests on the first day • Be consistent in our expectations on rounds • Help write notes when residents overwhelmed • Let residents “be the doctor”

  6. Rounds • SOAP note format • Avoid reporting the same information in more than one place • No need for reporting of non-involved organ systems • Improve quality of assessment- do NOT cut and paste (today’s assessment should be different from yesterdays)

  7. Rounds • Subjective: Overnight events (major) • Objective: • Vitals (ranges but if outliers, need to presents most common) • Exam • CNS • Resp: Vent settings, blood gasses, CXR result • CV: Inotrope, pressor doses, ECHO results, CVP/LA/PA line readings • FEN/GI: Weight, feeds, TPN, I/O’s, electrolytes • Heme: CBC, blood loss • ID: cultures, antibiotics

  8. Rounds • Nursing report • Respiratory/secretions- ready to wean, frequency of suctioning • ID- line days, foley days, can they come out? • Wounds • Pain • Correct any resident mistakes, omitted data

  9. RoundsAssessment • Assessment: 3yo female POD#4 from appendectomy now improving with a complicated postoperative course, including: • Problem list: No discussion or editorial comments, just the problems from head to toe, for example: • Respiratory insufficiency • Septic shock • Hypotension • Hypocalcemia • Anemia • Nutrition • Sedation/analgesia

  10. RoundsPlan If there is not an issue in that organ system, you do not need to discuss it! Think through the problem list and plan before rounds- this will help you stay organized

  11. Any questions???

More Related