| care of the critically ill
burn patient. There are four Bacteria Controlled Nursing Units (BCNU),
designed primarily for patients with significant risk of infection
from body surface area injury (i.e., thermal, chemical or electrical
burns and Toxic Epidermal Necrolysis (TEN)) and/or hypothermia. Non-burn
trauma and General Surgical ICU patients may also be admitted, space
permitting.
Typical of any ICU, the full range of hemodynamic
monitoring and associated therapies (i.e., arterial, central venous
and pulmonary artery pressures, use of vasoactive medications) are
utilized as appropriate to provide optimum resuscitation and management.
Continuous Renal Replacement Therapy (CRRT) is also available for
those critically ill patients requiring ultrafiltration and/or dialysis,
as is peritoneal and hemodialysis. Post anesthesia care is also
provided for the critically ill patients.
UNIT FOCUS
Meticulous wound care is the hallmark of
this unit. A variety of topical antimicrobials are utilized to promote
healing. Wound care includes cleansing, debriding and continual
reassessment of the wound bed followed by redressing. Procedures
such as escharotomies are performed by Physicians at the bedside
if warranted.
PATIENT CARE DELIVERY MODEL
The patient care delivery model is a patient-focused
model. Patient-focused care is high quality, comprehensive, accessible,
supportive and personalized care.
TEAM MEMBERS
Unit leadership is comprised of the Nursing Director, Clinical Nurse Specialist and Operations Coordinator. Each
member of the triad has a unique role through which to provide support
to the RN's and patients. The Nursing Director is ultimately responsible
for all aspects of the unit. Operationally the Nursing Director handles
all administrative issues, while the Clinical Nurse Specialist is
responsible for practice. This includes orientation, education,
staff development, patient outcomes as well as system support. The
Operations Coordinator is accountable for the environment of care
and support staff (eg. operation associates, unit service associates)
The RN staff is also supported in direct patient care by patient
care associates and critical care patient care associates. To inquire
about positions available on this unit, please contact Elizabeth
Behrmann at ebehrmann@partners.org.
SCHEDULING PRACTICES
Staff schedules are driven by patient need.
The scheduling process is staff driven and flexible to accommodate
personal and educational needs. Once the schedule is posted, the
staff manages changes with the approval of the Nursing Director.
STAFF ORIENTATION
All staff attend a one- week nursing orientation
program. Unit orientation is preceptor based and competency driven.
The first phase of orientation to Bigelow 13 is to the non-ICU populations.
The plan and length of orientation is individualized by the Nursing Director, clinical nurse specialist, preceptor and the new employee.
New nursing graduates participate in the New
Graduate Mentorship Program. Following completion of orientation,
staff work with the non-ICU populations until they begin critical
care orientation. The time for critical care orientation is determined
by the Nursing Director and Clinical Nurse Specialist in conjunction
with the employee, based on the CNS's assessment of practice. Critical
Care orientation is 12 weeks in length. It is also competency based
and includes didactic content provided by the ICU Consortium. Following
orientation, the nurse will spend concentrated time in the ICU,
but is expected to maintain competency is care of the non-ICU patients,
working on both areas of the floor.
EDUCATIONAL AND DEVELOPMENT OPPORTUNITIES
Staff education and development is supported
by The Norman Knight Nursing Center for Clinical & Professional Development. Full and partial day programs
are offered. Staff may also access outside educational opportunities.
The teaching environment provides staff with a daily opportunity
to discuss patient care related educational issues with members
of the graduate medical education program and with other members
of the care-delivery team.
Staff has time allocated and the necessary support
to offer educational programs to other staff members. Nursing Grand
Rounds programs are offered on a regular basis.
Staff RNs have the opportunity to participate
as a nurse preceptor. RNs may advance in their clinical practice
and demonstrate proficiency through the Clinical
Recognition Program. |
