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Published byCollin Shepherd Modified over 9 years ago
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ICU Housekeeping Nov 2013
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Outline The daily review Good practice points Paperwork Discharge planning
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Daily review Brief consultant led ward round, then need a thorough review Examine, check charts, check bloods, ask nursing staff Does the patient need parent/specialty review? Are we missing anything?
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A suggested structure… Airway Breathing Ventilator settings, gases, chest examination Circulation Circulatory status, inotropes Disability GCS, pain, actively look for delirium, sedation, sedation hold? Electrolytes Na/K/Mg/PO 4
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A suggested structure… Fluids 24hr balance, UO, urea & creat, renal replacement, fluid balance Gastro Abdo exam, nutrition, bowels, N&V, LFT’s Haem Hb, clotting, bleeding Infection WCC, CRP, Abx, lines
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…and the rest Review the drug charts Check for outstanding test results Is the patient on: LMWH? Chlorhexidine? PPI? What does the nurse think? Is there something missing?
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Good practice points VTE prophylaxis Ventilator and line care Gastric protection Delirium
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Paperwork Freehand clerking Proforma for discharge Try and use the electronic xray requests, paper accepted for now ICU specific charts
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Discharging Does everyone agree? Does the parent team know? Is there a plan for readmission/CPR? CVC peripheral? Active problem prevention – i.e. physio
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Summary The daily review Good practice points Paperwork Discharge planning Proactive care
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