Patient population (age, diagnosis, specifics about unit): The Advanced Care Unit is a 24-bed unit specializing in the care of acutely unstable patients that do not meet criteria for Intensive Care status but still require frequent, advanced assessments and interventions. Specific patient populations or conditions that require Advanced Care status include complex multi-trauma, uncompensated sepsis, continuous non-invasive ventilation, stroke, complicated withdrawal from alcohol or other recreational drugs, and DKA. The unit also includes an Epilepsy Monitoring Unit (EMU) where patients with seizure-like events can be safely taken off medication to purposefully induce seizure-like events and provide vital information to the Epilepsy Team about how to treat them.
Nurse to Patient ratio: 1:3
Department culture and resources: The Advanced Care Unit is a fast-pace, team-oriented unit. We work closely with our physician partners and ancillary team members to achieve the best outcomes for our patients. We have a robust Partnership Committee that meets monthly. We have a unit-based educator, a quality outcomes coordinator, 2 nurse supervisors and charge nurses.
Frequent nursing skills/equipment used: Minimum Q4 hour full RN assessments. Minimum Q2 hour vital signs. Continuous cardiac monitoring by primary RN, Foley/IV/NG insertions, arterial line/central line/chest tube monitoring and care, IV pumps, feeding pumps, lift equipment. Commonly used IV drips: amiodarone, diltiazem, insulin for DKA, dobutamine, heparin, octreotide.
Performs all responsibilities and duties required by unit as specific to the scope of service. Implements procedures and theories related to the specific area of practice. Maintains up-to-date and accurate documentation of nursing care provided to assure the integration of information for use by the healthcare team.
Completes initial assessment upon patient admission and develops appropriate plan of care in accordance with unit standards and that is based on patient and family needs. Implements plan of care, nursing interventions, and patient care procedures. Modifies plan of care based upon continuous evaluation.
Takes responsibility for patient and employee safety by reporting and/or correcting safety hazards and incidents.
Communicates with others directly and in private when necessary to resolve issues. Offers constructive feedback to assist in the professional development of peers, and confers with colleagues to expand knowledge base. Identifies own learning needs and takes initiative to begin appropriate solution.
Fulfills all requirements of departmental competencies.
Monitors EMU patients 24/7 for seizure activity
Ensures good communication with patients/family by utilizing meaningful hourly rounding, bedside shift report and whiteboards
Works with critical care team for Advanced Care patients
Works with hospitalists for Advanced Care patients